Pharmacists can play a key role in federal action plan to control hepatitis

Key Points

One component of a new federal action plan for controlling viral hepatitis calls for expanded delivery of hepatitis A and B vaccines through pharmacies, beginning in 2013. Pharmacists are well situated to carry out the plan's vaccination and treatment goals by identifying at-risk patients and managing side effects for those receiving new therapies.

Pharmacists have played a key role in flu vaccination in recent years, particularly during the H1N1 epidemic. That initiative showed that pharmacies are good locations to vaccinate people, said John Ward, MD, director of the division of viral hepatitis of the Centers for Disease Control and Prevention.

The action plan, titled "Combating the silent epidemic of viral hepatitis: Action plan for the prevention, care, and treatment of viral hepatitis," was developed by the U.S. department of Health and Human Services (HHS). It was written in response to an Institute of Medicine (IOM) report on hepatitis, which last year described hepatitis as an unappreciated health concern.

The action plan, which calls for new and better-coordinated efforts to manage viral hepatitis, is divided into 6 areas of concentration:

New therapies

The plan was published shortly before the approval of 2 new drugs for hepatitis C - telaprevir (Incivek, Vertex Pharmaceuticals) and boceprevir (Victrelis, Merck). According to FDA, both medications can significantly increase patient response and have the potential to decrease treatment duration.

During an interview given when the document was released, Dr. Ward termed pharmacists key educators of doctors, saying, "As these new drugs come online, [pharmacists] are going to have to play a critical role in educating providers in how they are appropriately used. These are complex drugs that bring a host of new management questions to the fore regarding resistance, when to initiate treatment, and how to monitor treatment and bring these drugs together."

Education

The action plan suggests that some healthcare providers who treat at-risk patients fail to address viral hepatitis, which often results in cases of chronic liver disease and death that could be prevented. Increasing provider awareness of viral hepatitis is essential to improving the delivery of preventive services, testing, and treatment options, and is a goal of the plan.

The action plan states that "Clinicians who treat patients with viral hepatitis will need guidance regarding use of more effective but more complex regimens, including decision support tools (e.g., standing orders, electronic physician reminders, and telemedicine consultations)."