Pacific Strategy Partners assisted The Cancer Council NSW (TCCN) develop a business case to reduce liver cancer via the pilot B Positive Project and a broader Australian intervention. TCCN is funding a pilot program in South-West Sydney that aims to reverse the exponential rise in liver cancer by targeting the prime driver, the incidence of chronic Hepatitis B infection amount Asian-born Australians.
Background: The Hepatitis B Challenge. Liver cancer is becoming increasingly common due, in part, to Hepatitis B:
- The liver cancer death rate in NSW has increased around 5 fold since 1972 and, at the current rate of increase, may double again by 2020
- Incidence is geographically skewed in NSW, with much higher incidence in south western Sydney, because the risk of liver cancer is much higher for migrants born in Asia, due primarily to chronic Hepatitis B virus (HBV)
- There are two large populations with high Hepatitis B incidence : Asian-born immigrants to Australia and Indigenous Australians; due to immigration patterns, NSW has the highest number of Hepatitis B infections in Australia
- The health system currently intervenes to prevent infection via vaccination or to treat liver damage, but does not manage chronic Hepatitis B well, since chronic Hepatitis B infection can remain undiagnosed for many years and is hard to treat once liver damage is evident
Hepatitis B Strategy. A strategic intervention in Greater Sydney would save 8,700 life years, with annual net cost of around $15m or $18,000 per life year saved:
- The proposed Screening and Surveillance Program will leverage existing health resources to fill the gap between prevention and treatment
- A Greater Sydney Program, if appropriately designed, could save 8,700 life years at a cost of $18,000 per life year, which compares favourably with other cancer screening programs
- The discounted lifetime program costs would be around $160m, with annual costs of around $15m after it is established, most of which would be covered by the Federal PBS. There is potential to improve program economics over time.
The B Positive Project
- TCCN has launched a pilot program for 2 years in 5 LGAs in South Western Sydney
- Hepatitis B Screening Strategy - Summary Document
- For more information on the B Positive Project visit : http://www.cancercouncil.com.au/editorial.asp?pageid=2457
- Read a recent Journal of Hepatology article, Antiviral therapy for hepatitis B-related liver cancer prevention is more cost-effective than cancer screening.
- Also read a review by Morris Sherman, Prevention of hepatocellular carcinoma: The holy grail of hepatitis B treatment