Peter Huskinson, and Professor Graham Foster, set out ongoing work to improve treatment for patients with chronic hepatitis C:
NHS England announced last summer the single biggest new multi-million-pound treatment investment of the year by the NHS would be in hepatitis C.
The new treatments this funding allowed us to roll out offers real hope for patients. In many cases they can effectively be cured of the virus, and the drugs are much easier to take than older treatments.
Importantly, the funding also enabled us to set up 22 Operational Delivery Networks to help deliver equitable access to these treatments across the country, identifying and addressing regional variation in the number of quality of services.
These networks, or ODNs, comprise specialist centres working in partnership with other local care services and professionals, and have been allowing clinicians to ensure that those with the greatest need – up to now, those with cirrhosis – get speedy access to treatment.
And now they will be instrumental in helping NHS England meet the significant challenge of rolling out the new oral treatments for chronic hepatitis C approved by NICE at the end of last year.
The NHS has already treated the majority of people with cirrhosis of the liver caused by chronic hepatitis C – nearly 5,000 individuals in total.
Now we are committed to doubling the number of treatments to 10,000 patients in 2016-17.
This is a remarkable, life-changing advance in care for the NHS in a short space of time, and is testament to the clinical leadership and partnership between healthcare providers that has been established so quickly.
But it is also clear that this promising advance in medicine presents a real budgetary challenge to the NHS due to the numbers of potential patients and the very high aggregate cost of the treatments involved.
Our priority as stewards of this programme – working with the ODNs and clinicians across the country – is therefore to ensure that every penny invested in this area achieves the most health benefit possible.
Whilst NHS England has made the tough prioritisation choices necessary to free up funds to invest significantly in new treatments, and will continue to do so, pharmaceutical companies also need to play their part; quite simply, making faster progress for patients in eliminating this disease will depend on pharmaceutical companies making them more affordable.
We are already seeing promising signs, although there is much more to do, and we hope all companies will follow the example of those who have been the first to improve their prices.
But, of course, people living with chronic hepatitis C will be more concerned with how soon they will be able to access the new oral treatments.
It’s clearly not possible for everyone to be treated immediately; notwithstanding the very high cost of the treatments, there are clinical and logistical limits on how quickly patients can be assessed, monitored and treated.
That’s why NICE recognised in its latest guidance that to treat all patients with chronic hepatitis C is going to take several years, and that decisions on which patients should be the first to access these new drugs should be taken by clinicians, working together as part of ODNs.
We would therefore encourage people living with chronic hepatitis C who want to find out more to speak to their clinician – all those working within ODNs have been issued with guidance and should be able to answer any questions.
We look forward to keeping you updated on the key milestones and developments in this important treatment programme over the coming months and years, and please do let us have your comments and feedback.
Peter Huskinson is the National Commercial Director of specialised Commissioning in NHS England. He joined the NHS in 2003 after a successful career in industry, and has worked in a range of commissioning and transformation roles with responsibility for primary, community acute and mental health care.
He co-chairs NHS England’s National Programme of Care Board for Blood and Infection overseeing the work of clinical reference groups in infection, immunity and haematology.
Professor Graham Foster is Professor of Hepatology at Queen Mary University of London and the clinical lead for hepatology at Barts Health.
Professor Foster was the founding President of The British Viral Hepatitis Group, a past President of the British Association for the Study of The Liver and is a trustee of the Hepatitis C Trust. He was appointed as National Clinical Chair for the Hepatitis C Delivery Networks in January 2016.