Sorry, its a naming issue. The recommendation is for s85 but we’ve always referred to the doctors as “s100 prescribers”. We might have to say “hep C prescribers” instead. But you raise a good point, this needs some clarification.

Things are different in Australia. Our Government pays per cure regardless of the length of treatment so what the accountants say makes little difference. I don’t know how the US or Thailand develop their treatment guidelines, but in Australia, they are comprehensive, evidence based and published for every doctor to use.

Suggesting that people could /should make their own decisions on what drug combination they need and how long their treatment should last is extremely dangerous practice and is the prime concern in the medical community regarding the buyers club. Treatment guidelines provide indisputable evidence based recommendations on which medication is suitable for patients depending on genotype, fibrosis, treatment history, comorbidity, etc. Nobody should undertake hep C treatment without the supervision of a suitably qualified doctor.

I don’t know exactly, but it is done using mathematical modelling by estimating the prevalence within particular populations and extrapolating that to the size of population. Thankfully we have the Kirby Institute to guide us on this and many other measures of how Australia is responding to hep C

Australia has one of the highest diagnosis rates in the world – around 80% are diagnosed. The 230,000 affected in Australia is an estimate but there is a high degree of confidence in the estimate. On these figures, there are only 46,000 undiagnosed. Some of these would be Aboriginal people in remote communities and people from non-English speaking backgrounds.

Many people do not actively engage in their health care. Helping themselves is not a concept they understand. People like this will need to have their hand held every step of the way and that will be an important role for all of us once we have been cured.

People on this site are not typical of people with hep C. Many people have complex lives in which hep C is just one of a number of problems. Others are still using (or in prison and using) and realise they might be reinfected, or their lives are too chaotic to manage the treatment. Similar treatment for HIV has been available for 20 years and treatment rates are still below 50% in some jurisdictions (even though HIV is fatal for everyone without treatment). The challenge will be to encourage everyone with hep C to be treated, but I believe it will take at least 20 years, a major effort to tackle stigma and discrimination and a huge expansion in models of care.

That’s interesting James, and I don”t doubt you are right, but some drugs are more effective with different genotypes eg Viekira Pak with 1b. Wouldn’t it be better if Government negotiated the best price for a cure for each genotype.