Hepatitis C: Policy in Action
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1 MEP FRIENDS OF THE LIVER GROUP MEETING Hepatitis C: Policy in Action 22 nd March 2017 Brussels, Belgium RICARDO BAPTISTA LEITE, MP, MD, PhD(C) Medical Doctor and Member of the Portuguese Parliament Member of the Parliamentary Health Committee Foreign Affairs Committee Head of Public Health Católica University of Portugal Guest Lecturer NOVA Medical School and NOVA Information Management School City Councilor of Cascais
2 Portugal: Cascais Sintra Estoril Coast
3 Health in the Portuguese Constitution CITIZEN CENTERED UNIVERSAL COVERAGE ACCESS GLOBAL QUALITY PORTUGUESE NHS TENDENCY TO BE FREE OF CHARGE
4 The Evolution of Healthcare in Portugal LIFE EXPECTANCY AT BIRTH INFANT MORTALITY RATE (PER 1000 LIVE BIRTHS)
5 The Evolution of Healthcare in Portugal HEALTH EXPENDITURE PER CAPITA BELOW THE AVERAGE OF OECD COUNTRIES (OECD, 2011) PORTUGAL
6 The Evolution of Healthcare in Portugal ECONOMIST INTELLIGENCE UNIT TOP TIER BY OUTCOMES (EIU, )
7 2011
8 Hepatitis C in Portugal
9 Consensus for HIV T/2013 May June - December December Febuary 2015 Today
10 HCV Paradigm Shift T/2013 Católica University of Portugal Institute of Health Sciences Public Health Unit May June - December Consensus Method December Review scientfic data Febuary Collect 2015 data from main stakeholders Today (Think Tank) Consensus paper to support future decisions on how to manage hepatitis C in Portugal, from a public policy perspective: from prevention to cure
11 HCV The Research to Policy Gap Only ~50 patients with Hepatitis C were treated with 3rd May June generation 2T/2013 antiviral drugs (special authorizations) December Negotiations between Ministry of Health and Pharma Industry went on behind closed doors. Absolute uncertainty on what would be the outcome of those negotiations. December Private hospitals were charging over 100k Euros to treat Hepatitis C. Febuary 2015 Today Advocats from all fields were demanding a decision, including a possible patent violation (under the Doha treaty), to save lives.
12 HCV The Research to Policy Gap T/2013 May June - December December February Today
13 The Tipping Point T/2013 May June - December December February 2015 Today DON T LET ME DIE! José Carlos Saldanha
14 HCV When Research meets Policy February days later The Ministry of Health announced an agreement with Gilead Sciences and Harvoni was fully funded for all patients with Hepatitis C. Risk sharing model was adopted. The Ministry agreed on paying per patient that is clinically cured (not per number of weeks of treatment nor per number of patients treated) and the payment procedures were fully centralized. Volume-based agreement: Price paid is inversely proportional to the number of patients treated. National Action Plan for Hepatitis C and the review of the national HCV treatment guidelines were announced and are currently being prepared by a panel of experts. Centralized registry database was commissioned and is currently used by physicians.
15 Hepatitis C in Portugal Today Over 15,000 patients that have been diagnosed with chronic HCV in the NHS have been included patients have initiated treatment PATIENTS CURED 96,47% SVR Source: Ministry of Health PT, 3rd February 2017 pathtozero.eiu.com
16 Making Change Happen 2016 Vienna, Austria Policy change is possible using EDD: vidence-based ata-driven ecision-oriented Policy Making
17 LET S END HEPC: ROAD TO ELIMINATION DASHBOARD Institute of Health Sciences Católica University of Portugal Public Health Unit DECLARATION OF INTERESTS Gilead Sciences Europe Ltd is providing financial support for this project.
18 LET S END HEPC Road to Elimination Dashboard 1 Elimination demands a holistic approach: Awareness and Prevention strategies Diagnosis of all cases of HCV Ensure linkage-to-care for all patients diagnosed Guarantee access to treatment 2 Still, we face regional disparities: No surveillance mechanisms available It has become impossible to assess if we are truly on the road to eliminate Hepatitis C We are unable to perform a comparative analysis at the country level Lack of appropriate tools needed to make evidence based decisions
19 LET S END HEPC Road to Elimination Dashboard 3 We need a tool that integrates Open data policy surveillance digital platform Indicators from each link of the Hepatitis C value chain : Awareness & Prevention Diagnosis Linkage to Care Treatment Cure Country comparative analytic tools at the service of all Prospective impact assessment of indicator adjustments
20 LET S END HEPC Road to Elimination Dashboard
21 LET S END HEPC Road to Elimination Dashboard
22 More needs to be done THE ANSWER If Europe doesn't take on a leadership position, any hope of meeting commitments to end the epidemics of HIV and AIDS, [hepatitis] and tuberculosis by 2030 will be doomed to fail. Renate Baehr in Politico With the support and under the auspices of
23 And Lastly Never, Never, Never, stop fighting for better health for all
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