Abstract
Hepatitis C virus (HCV) causes both acute and chronic infection, which can potentially develop into cirrhosis and liver cancer. Healthcare systems are struggling to finance costly direct-acting antiviral agents through public funding for uninsured patients, despite the unprecedented high cure rates of these agents. Vulnerable populations are at higher risk of HCV infection. The personal importation scheme is based on the legal right to import any unauthorized generics for personal use. This study was designed to assess the knowledge and perceptions of stakeholders on unauthorized generics. We conducted an anonymous online survey based on the fictitious situation of a patient diagnosed with HCV who lacked mandatory health insurance and personal financial resources. We obtained a sample of 781 respondents: 445 physicians, 77 pharmacists, 51 patients and 207 non-healthcare professionals. We found that only 36% and 58% of respondents believe that the quality and efficacy, respectively, of unauthorized generics are equivalent to their corresponding brand. An overwhelming majority (98%) favoured quality control upon arrival, and 31% felt they could recognize fraudulent websites. A total of 79% expressed support for financial assistance for vulnerable patients, and support among physicians was 83%. Overall, the limited knowledge of the efficacy and quality of unauthorized generics, despite evidence in peer-reviewed literature, contrasts with the overwhelmingly positive attitudes toward financial assistance for personal import. This finding emphasizes the need for clearer information on imported generics and the potential safety provided by buyers' club schemes to complete the WHO agenda of eradicating viral hepatitis by 2030 within otherwise excluded vulnerable populations.
Highlights
BackgroundChronic hepatitis C virus (HCV) infections affect an estimated 71 million people.[1]
We found that only 36% and 58% of respondents believe that the quality and efficacy, respectively, of unauthorized generics are equivalent to their corresponding brand
It was years before drug prices decreased sufficiently for these access limitations to be removed by the Federal Office of Public Health (FOPH) in 2017, thereby allowing insurance coverage for all insured persons in Switzerland. [4, 5] access issues remain for vulnerable individuals not covered by mandatory healthcare insurance, people living in prisons (PLP), people who inject drugs (PWID) and migrants, for whom HCV prevalence remains high and access to treatment is limited.[5,6,7]
Summary
BackgroundChronic hepatitis C virus (HCV) infections affect an estimated 71 million people.[1]. As a cost-saving measure, the Swiss Federal Office of Public Health (FOPH) limited insurance coverage for DAA treatment to only those diagnosed with an advanced form of the disease. It was years before drug prices decreased sufficiently for these access limitations to be removed by the FOPH in 2017, thereby allowing insurance coverage for all insured persons in Switzerland. It was years before drug prices decreased sufficiently for these access limitations to be removed by the FOPH in 2017, thereby allowing insurance coverage for all insured persons in Switzerland. [4, 5] access issues remain for vulnerable individuals not covered by mandatory healthcare insurance, people living in prisons (PLP), people who inject drugs (PWID) and migrants, for whom HCV prevalence remains high and access to treatment is limited.[5,6,7]
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