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Costs, lack of referrals hinder patient access to HCV services in Egypt

NEW YORK — Egyptians with hepatitis C virus infection face many barriers, including a lack of referral and counseling services and financial constraints, in gaining access to services for the virus, according to data presented at the AASLD/EASL Special Conference on Hepatitis C.

Researchers, including Moaz Abdelwadoud, MD, MPH, associate researcher of public health, Theodor Bilharz Research Institute, Egypt, conducted a literature review using a modified Piot conceptual model to identify factors, positive and negative, that have influenced access to HCV services in Egypt. The barriers included: budgetary constraints and burdens, unavailable counseling and referral services, patients’ negative views about quality of service, low efficacy of available interferon-based therapies, limited pediatric services, sham remedies and misbeliefs about HCV and treating it.

Moaz Abdelwadoud

Factors that influenced easier access to HCV services included: awareness of HCV among the general population, government-subsidized financial schemes and an organized health information system.

“The existing health information system provides an opportunity for national registry for people living with HCV, retrieval of defaulters, e-learning packages supporting clinical decisions and simplification of administrative procedures,” the researchers wrote.

The researchers deemed the influencing factors “interacting and interdependent,” and said that adding psychologists to health care teams, creating more peer support groups and strengthening pediatric services, were positive recommendations to improve access to HCV services for patients.

“More efforts are needed to improve competencies of providers, enforce social research and clinical trials on genotype 4 direct-acting antivirals, raising awareness among high risk groups and fighting fake remedies,” the researchers wrote.

"Egypt is best positioned to confront hepatitis with the recently subsidized oral Sovaldi by Gilead with almost 99% discount compared to the US price," Abdelwadoud told Healio.com/Hepatology. "However, the other structural barriers beside costs and interferon side effects are still threatening the favorable targeted outcomes." – by Melinda Stevens

For more information:

Abdelwadoud M. Abstract #26. Presented at: AASLD/EASL Special Conference on Hepatitis C, Sept. 12-13, 2014; New York.

Disclosure: The abstract was extracted from a thesis submitted in partial fulfillment of the requirement for the degree of master of public health at the Royal Tropical Institute, in cooperation with Free University of Amsterdam.