'This is a life and death matter'
Shelter director says $55,000 cost of new curative Hep C medication shouldn't prevent its use in territory
Meagan Leonard
Northern News Services
Friday, March 13, 2015
SOMBA K'E/YELLOWKNIFE
The high price of a new curative Hepatitis C treatment should not be a factor when the city's poor are suffering from the disease, says Centre for Northern Families executive director Caroline Johnson.
The medication is called Holkira Pak, has a 95 to 100 per cent cure rate and is available in Canada – but the NWT along with most other jurisdictions across the country remain hesitant about purchasing the drug, which carries a $55,000 price tag for each treatment.
Johnson says it is unfair for wealthy bureaucrats to speak on behalf of those who are ill and living in poverty.
"Once a cure has been found for a deadly contagious disease, is it our politicians' right to deny this based on short-term costs?" she said.
"We are basically saying, only those who can afford to purchase the medication at their own cost shall be cured."
In February of this year, Prince Edward Island became the first province to offer Health Canada's newly-approved 12-week oral treatment with few reported side effects. The province has pledged $5 million, while the rest of the country contemplates the hefty cost. There are other modes of treatment available but they take much longer, have harsher side effects and are not as effective.
Andre Corriveau, chief medical officer for the GNWT, said because the drug is so new and high in price, governments will be weighing their options carefully in terms of cost/benefit.
"It's not like there are no existing treatments right now, so given the high cost of the new medication, what is the added benefit on the money we already spend?" he said. "Even though they seem to be more effective from the evidence that's been put forward, they're not without side effects as well, so there's more work that we need to do."
He says cases of Hep C in the territory are actually declining, peaking at 35 new instances every year between 2000 and 2005, but afterward dropping off to 15 per year. He attributes this to an increased push for testing. It couldn't be determined by press time how many Hepatitis C related deaths, if any, there have been in the territory.
"Before the testing was not as accurate and we also weren't promoting the testing as much," he explained. "In the past year we revised the guidelines in the Northwest Territories and we're really encouraging people to get tested."
Corriveau says stricter health guidelines have gone a long way in reducing numbers.
"Most are people who share needles for injection drug use, some people may go to tattoo parlours that are not licensed … and then there's the occasional outbreak linked to dental offices," he said. "Most of the time now it's people sharing injection equipment."
Johnson said she has witnessed the disease firsthand.
"I know that hepatitis is alive and well in Yellowknife because I run the homeless shelter," she said. "I know that youth within our community are sexually active and not everyone in the community is using protection so if there's one person with it then there is the potential of having more people with it."
Denying the public such medications is a disservice to those already living on the margins of society, she said, adding a decision should not be based on cost/benefit when lives are at stake.
"When they base it on cost and say we're not going to cover it … it's the working poor who are penalized for that," she says.
"This is a life and death matter – it's not like getting a cold."
She added the cost of treating long-term complications associated with Hep C are potentially more detrimental to the taxpayer's cheque book.
"Not utilizing the drugs can mean a lifetime of medical appointments, medications and the possibility of a liver transplant," she said.
Ultimately, Corriveau says most governments will be waiting for the drug review to come back before making a decision.
"We know Hepatitis C is prevalent in the North, anybody who is engaging in unsafe practices in regard to injection drug use and tattooing puts themselves at risk," says Corriveau.
"Decisions will be made and even though PEI has gone ahead at this point, most provinces are going to wait before making a decision on it."
Holkira Pak is currently under review at the Canadian Agency for Drugs and Technologies in Health who declined comment during the process.
"It is not our policy to comment on any drug that is currently pending a review by the Canadian Drug Expert Committee," said knowledge and exchange officer Andrea Tiwari.
"The committee is scheduled to review this drug at its May 2015 meeting."
In 2007 there were 483 deaths related to Hepatitis C in Canada.
