KUALA LUMPUR: About 400,000 Malaysians have Hepatitis C, but only a fraction can afford the medication, which may cost up to RM300,000 for the full course of treatment.
Malaysia is not given special pricing for the drugs by pharmaceutical companies because it is considered a middle-income country.
The Health Ministry has teamed up with the Drugs for Neglected Diseases Institute to come up with an affordable cure.
In the meantime, patients have to fork out a huge sum for medication, try to get into clinical trials for other potential cures or seek treatment in other countries.
Universiti Malaya Medical Centre consultant hepatologist Prof Dr Rosmawati Mohamed (pic) said more than 500,000 Malaysians aged between 15 and 60 were estimated to be infected with Hepatitis C.
Of this number, 74% or 386,000 have active or persistent infection.
“A lot of people are not aware that they are infected. Because they have no symptoms, the illness is not detected,” she said.
Dr Rosmawati said Hepatitis C was a silent global epidemic of the 21st century.
“The progression is not just silent but slow. From the time they get infected to development of cirrhosis and its complications, it takes 20 to 30 years,” she said.
Dr Rosmawati said with persistent liver injury or inflammation, whether it is Hepatitis B or C, the liver damage progresses in the same manner – first with liver scarring or fibrosis, and after many years of fibrosis and injury, the whole liver gets scarred (cirrhosis). Some patients develop liver cancer.
Hepatitis C is transmitted mainly through blood, with nearly 60% of cases in Malaysia related to previous drug use through shared needles.
Other infections occur through tattooing, body piercing, sharing of personal items such as razors, accidental injury when handling contaminated needles and dialysis.
Those who had blood transfusions or organ transplants before 1994 are also at risk of infection because there was no testing for Hepatitis C in Malaysia then.
The risk of transmission through transfusion is now rare because all blood is tested, Dr Rosmawati said.
“Our Hepatitis C disease burden in Malaysia is actually quite high. Not just the prevalence, but also the damage,” she said.
Early detection and treatment are vital because the longer the duration of infection, the higher the healthcare cost and risk of complications.
The good news, she added, is that Hepatitis C is curable, unlike Hepatitis B and HIV. The cure rate is almost 95% but the cost is prohibitive.
In public hospitals, patients are treated in a clinical trial setting while others pay for the medication. Private insurance does not cover Hepatitis C.
Positive Malaysian Treatment Access and Advocacy Groups director Edward Low urged the Government to take advantage of World Trade Organisation member privileges to issue a compulsory licence authorising a local import company to bring in the generic drug, or have it manufactured in the country.
“The Government has the right to issue compulsory licensing for non-commercial use only. This right (may be exercised) without the drug patent holder’s consent if an agreeable price cannot be negotiated,” Low said.
Governments in the world have not done this out of concern that big pharmaceutical companies may accuse them of breaching patent rights, he added.
Such negotiations are under the purview of the Domestic Trade, Cooperatives and Consumerism Ministry, which said the matter was a private and confidential one, and it could not divulge anything yet.
Meanwhile, the Health Ministry said it was working on making the drugs affordable.