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Pharmacists asked to "think again" about roles in hepatitis

Hepatitis: Think Again, is the theme for this year’s World Hepatitis Day on 28 July. The International Pharmaceutical Federation is encouraging pharmacists to “think again” about their roles in hepatitis prevention and treatment.

It has been an eventful few months for hepatitis. The World Health Organization issued new recommendations on treating hepatitis C in April and the World Health Assembly adopted a resolution to improve prevention, diagnosis and treatment of viral hepatitis in May. Moreover, since the previous World Hepatitis Day two new direct-acting antivirals (sofosbuvir and simeprevir) have been launched and there are more in the pipeline.
The advent of such new medicines that seem set to change the face of hepatitis management have, however, been marred by pricing challenges. At the 49th International Liver Congress, held in London, UK, in April, the World Health Organization called for these new medicines to be first-line treatments yet also for concerted effort to drive down their costs.

Crucial roles for pharmacists
“It is good news that there are new and more effective treatments coming on the market, but their price may be a challenge for even developed countries. If governments and health insurers are to cover the costs of these medicines, they would like to ensure that the investment will result in expected outcomes as measured in clinical trials. The input of pharmacists in ensuring responsible use of these medicines is, therefore, crucial,” Luc Besançon, CEO and general secretary of FIP, points out.

Ensuring responsible use of medicines for hepatitis includes providing medication counselling, follow-up to ensure adherence and identifying problems such as adverse effects. Counselling often includes advice on alcohol and over-the-counter medicines that affect the liver. Some countries have seen “specialty” pharmacies opening and there is some evidence from the USA that the provision of care from these pharmacies improves adherence.

But in fact, pharmacists have been demonstrating the important roles they can play in hepatitis prevention and diagnosis as well as in the care of those who are infected. Pharmacies have shown that they are able to perform blood tests for hepatitis, with evidence from the UK pointing to higher proportions of diagnosis than GP surgeries. FIP’s Pharmacists Organisations and Pharmacists’ Activities Database (POPAD) also holds information on community pharmacies in Australia and Austria playing a part in raising awareness of hepatitis, testing and vaccinations. Hepatitis vaccinations (hepatitis A and B) are being administered through pharmacies, and for many years pharmacists have been supporting prevention through providing drug misuse services and needle exchange, and advising on good hygiene practices. The scope for pharmacists to contribute to preventing and managing this disease, which is estimated to kill almost 1.4 million each year, is wide, adds Mr Besançon.

For World Hepatitis Day 2014, FIP asks pharmacists around the world to “think again” about the roles they are playing and the roles they can play. This year’s campaign, organised by the WHO and the World Hepatitis Alliance, contains a number of key messages linked to awareness, prevention, treatment, vaccination, stigma and sporting events. A campaign toolkit, which includes posters that pharmacists might like to display, is available here.