OBJECTIVES: To assess the uptake and utilization of newer therapies for Hep-C between 1999 and 2019 in Manitoba.

METHODS: A population-based retrospective study was conducted using data from the Manitoba Centre for Health Policy (MCHP) repository. Using the test results provided by the Cadham provincial laboratory (CPL), individuals in Manitoba with any diagnosis (acute and chronic) of HCV infection (based on positive HCV RNA) were identified. Using Drug Program Information Network (DPIN) database, those receiving treatment constituted the ‘users’ population. Using the ATC codes, all formulations of Hep-C medications was studied in both treatment-naive and treatment-experienced patients.

RESULTS: A total of 2,517 individuals with HCV had filled at least one prescription for treating Hepatitis-C in Manitoba between 1999 to 2019. These individuals were stratified based on the treatment received as “interferon-based group” (n=933) and “DAA group” (n=1,584). The overall mean age of the individuals were 42.2 ± 11.2 years, the majority of the individuals were males, belonged to the 25-64 years age group (adults), lived in an urban region and belonged to the lowest income quintile (Q1). The uptake of treatments for HCV infection during the study period increased from 4.1% in 1999 to 56.6% in 2018. Overall, there were 36,359 (20,341-INF based and 16,018-DAA-based) prescriptions dispensed for HCV infection in Manitoba between 1998 and 2019. The most commonly utilized DAA regimens included sofosbuvir + velpatasvir (43.4%, 6958 prescriptions) and sofosbuvir + ledipasvir (28.4%, 4557 prescriptions). Genotype-1 (66.1%, n=1,014) was the most common among individuals with HCV infection in Manitoba.

CONCLUSIONS: After their introduction, a rapid uptake of newer DAAs was observed in Manitoba and by the end of 2019 DAAs had taken the entire market of HCV medications. Although uptake of DAAs in Manitoba was enthusiastic, efforts are needed to further increase DAA use in order to achieve the goal of HCV elimination.