Specialty Pharmacists Play a Vital Part in the Treatment of Hepatitis C

Pharmacists provide medication expertise that is essential to both the patient and the health care team in the treatment of hepatitis C.

The management of hepatitis C virus (HCV) infection has changed dramatically with the recent introduction of drugs such as Harvoni, Sovaldi, and Olysio to the market. There are numerous treatments now available for the HCV patient, ranging from interferon-free, all-oral regimens to those complemented with interferon and ribavirin.

The availability of so many treatment options provides an opportunity for community pharmacists to play a key role in the management of the HCV patient. A pharmacist can help to educate all stakeholders about the various combinations of medications and the value of adherence in achieving a positive outcome.

In the past, treatment of HCV required the use multiple agents. The selection of these 2 or 3 agents and the length of treatment were based on the patient’s HCV genotype and prior history. Although the new all-oral therapies mentioned above have easier-to-manage regimens, it is still incumbent on the pharmacist to ensure the patient starts therapy correctly. It is also the pharmacist’s job to monitor the patient’s adherence to therapy to help ensure a positive outcome.

In the community setting, some pharmacy practices have created support groups for patients where they can share their experiences on therapy and build a support system. Many patients are apprehensive about initiating therapy and may have concerns about the cost of therapy. The pharmacist is in a good position to help alleviate some of these fears and to ensure the patient gets the reimbursement support needed to help their adherence to the treatment regimens.

By providing patient counseling, community pharmacists have the opportunity to dispel some of the myths associated with these therapies and to educate patients on matters related to HCV infection, including the adverse effects a patient can expect, the duration of the therapy, and what medications can be used concomitantly while on HCV therapy. In addition, pharmacists are in an ideal position to provide clarification and recommendations to primary care and specialty providers regarding the selection of appropriate therapies for individual patients.

There are a number of clinically significant drug interactions associated with the use of these new regimens, and pharmacists can provide guidance in the identification and prevention of these adverse effects. By sharing their knowledge of HCV treatment options, pharmacists position themselves as an important part of the multidisciplinary care team. In essence, the pharmacist can become a mentor to the patient and play a critical role in maintaining adherence and achieving success with therapy.

Management of HCV infection will continue to evolve as additional therapies are approved and new regimens are created. The pharmacist can also play a role in keeping the provider abreast of new developments in HCV therapy and helping patients to navigate the maze of prior authorization and step therapy edits required by the majority of managed care organizations in the United States.

At the end of the day, the pharmacist can evolve into a strong asset of the overall HCV health care team. The pharmacist can counsel and mentor the patient while helping the provider to get the patient on therapy quickly. In this way, the pharmacist becomes a trusted aide to the specialist and a cheerleader and mentor to the patient at a crucial time. SPT

About the Author

Nicodemo “Nick” Calla, RPh, JD, is vice president of industry relations for Cardinal Health Specialty Solutions.