Chronic viral hepatitis C micro-elimination program using telemedicine. The Mexican experience

Area of Science:

• Hepatology
• Public Health
• Digital Health

Background:

• Hepatitis C virus (HCV) infection poses a global health challenge, leading to fibrosis and cirrhosis.
• Direct-acting antiviral (DAA) drugs offer effective treatment for chronic HCV.
• Telemedicine presents a viable solution for extending healthcare access to remote areas and reducing costs.

Purpose of the Study:

• To implement a microelimination program for HCV using DAAs.
• To leverage telemedicine to minimize treatment-related expenses.
• To assess the efficacy and cost-effectiveness of a telemedicine-supported HCV treatment program.

Main Methods:

• A national HCV microelimination program was established at Petróleos Mexicanos (SMPM).
• Patients with chronic hepatitis C were categorized as locals or outsiders.
• Outsider patients received HCV treatment indicated, monitored, and completed via telemedicine to avoid travel.

Main Results:

• The study included 136 patients (74 locals, 62 outsiders).
• Telemedicine avoided travel for 62 patients, saving an average of $3,176.20 USD per patient, totaling $196,924.40 USD.
• Treatment coverage reached 86% (30 patients untreated due to medication shortage), with a 99% sustained virological response (SVR) rate and minimal adverse events (5% headache/fatigue).

Conclusions:

• A telemedicine approach facilitated significant cost savings in HCV treatment, particularly for the 45.5% of patients who were outsiders.
• The program achieved 86% coverage and a 99% success rate in sustained virological response (SVR) using DAAs.
• Telemedicine is an effective strategy for HCV microelimination, enhancing accessibility and cost-efficiency.