On World Hepatitis Day…. Chairman’s Thoughts

Today is World Hepatitis Day, marked on 28thJuly each year. Globally there are over 400 million people living with hepatitis currently, with an annual death toll of 1.34 million. The numbers are serious.

And yet treatment for Hep C has never been more simple. There is now a 12 week course of medication that is quicker than before, has few of the previous side effects (such as nausea) and has a success rate of over 90%. 

A little like the situation with PrEP and HIV, insurers have been slow to catch up with the current medical advances. As we have written previously, it took a long time for insurers to recognise that if a customer is undetectable and on stable medication there is no additional risk for travel and therefore there should be no additional premium charged. We were one of the first insurers not to charge any extra for customers with HIV, and we were the first (and still only) insurer that doesn’t require a customer to disclose their HIV status if they are undetectable, at no extra charge.

This is clearly a huge advance in the treatment of Hepatitis C, but the problem with any new drug is the cost – treatment in the UK costs the NHS £30,000, and a patient can pay up to £50,000 privately. Again, as with the initial availability of PrEP, there are some ways people are trying to work around this. Here’s a comment from Torquil McLusky of Pulse Insurance (one of our underwriters):

“There are ways around the cost issue. India has taken the radical step of allowing generic hepatitis medicines to be sold: Indians can complete a full 12-week course for a few hundred pounds, a fraction of the cost of treatment in the UK (it is worth remembering that the drugs themselves are well proven anti-virals, it is their use in combination and as a treatment for hepatitis that is new).  Indeed, there are now “buyers’ clubs” that allow people in the UK to purchase drugs from India so that a full course of treatment costs around £1,000.”

So how can insurers react to the new Hepatitis C treatments? Until/if ever the law is changed to allow generic drugs earlier (very unlikely) there are some practical steps to take, such as allowing costs of drugs bought semi-officially through buyers’ clubs to be reimbursed, training our staff to be sensitive about this illness and the groups that it can affect, and to keep up with medical advances. All too often, underwriters are resistant to change in spite of medical evidence. We should empower our organisations to take a more commercial and practical view. That is what Emerald has been trying with its underwriters, and we hope that our changes to our travel policy for customers living with HIV are just the start.

And there is a further compounding factor with HIV and Hepatitis generally. Although risk of transmission of Hep C through sex is low (unlike with Hep B) the increased use of PrEP has resulted in an increase in other STIs[1], so we need to be aware of whether this situation increases risk (and whether new treatments reduce that risk). Insurers should keep up to date on facts, not overreact to risk, and understand the need to be sensitive to the needs of their customers. This is what we try to do with Emerald, and we continue to work with the insurance sector to empower change. Thank you for your continued support!

You can read more about how Emerald is different here.