Hepatitis C treatment trends in Canada: Health Infobase

On this page

• Importance of hepatitis C treatment
• About the data
• Hepatitis C treatment trends
• Significance and next steps
• References
• IQVIA disclaimer

Importance of hepatitis C treatment

Hepatitis C is a liver infection caused by the hepatitis C virus (HCV). It can lead to chronic liver disease, and eventually to cirrhosis, liver failure, and liver cancer. Hepatitis C is considered a sexually transmitted and blood-borne infection (STBBI) and is primarily spread through blood. In Canada, we estimate that 0.56% of the population, or 214,000 people, were living with chronic hepatitis C in 2021 ^{Footnote 1}.

People living with chronic hepatitis C now benefit from direct acting antiviral (DAA) medicines. This revolutionary treatment can cure more than 95% of people treated. It has made the global goal of ending the hepatitis C epidemic by 2030 achievable ^{Footnote 2}. DAAs reduce the risk of complications and death, improving the lives of people living with hepatitis C. Treating and curing hepatitis C also helps prevent the virus from being passed on in communities.

DAAs were introduced in Canada in 2014 and access increased between 2015 and 2018. Since becoming widely available, it’s estimated that more people are receiving treatment than there are new infections each year ^{Footnote 1}.

Some populations in Canada experience ongoing hepatitis C transmission. By increasing treatment in these populations, we reduce transmission and new infections ^{Footnote 3}. In addition, every person cured helps lower the number of people living with chronic hepatitis C in Canada ^{Footnote 4Footnote 5}. It is essential to promote treatment to improve the health of people living with hepatitis C in Canada and to eliminate hepatitis C as a public health concern.

About the data

At the Public Health Agency of Canada (PHAC), we examined hepatitis C treatment trends between 2012 and 2023 nationally and by province. We used pharmaceutical data purchased from the private company IQVIA Solutions Canada (IQVIA).

IQVIA collects dispensation data (information about the type and quantity of medication given out by pharmacists) using a representative sample. It includes over 83% of total dispensed prescriptions in Canada, either from:

• prescriptions dispensed by community pharmacies
• prescription estimates for correctional facilities and government distribution through sites like hospitals and community health clinics

The British Columbia Centre for Disease Control estimated the number of people on hepatitis C treatment between 2012 and 2016. They used dispensation data from IQVIA. For 2017 to 2023, a proprietary algorithm within IQVIA was used to project patient counts from sampled outlets to the entire population of each province.

Hepatitis C treatment trends

A descriptive analysis of counts of people on hepatitis C treatment over time by sex and by province.

National trends

Since DAA treatment was introduced in Canada in 2014, uptake of hepatitis C treatment increased steadily as it became widely available. Nationally, treatment uptake peaked in 2018, driven mostly by trends in more populous provinces. Uptake began to decline in 2019. National treatment levels decreased further during the years most affected by COVID-19 (2020 to 2022). This is not surprising, as demand for and access to prevention and care services for STBBI, like hepatitis C, declined during this period ^{Footnote 6}. The estimated number of people treated annually remained stable at around 9,500 people in 2022 and 2023. The national trends mask provincial variations.

Figure 1: Estimated number of people treated for hepatitis C annually, by sex, Canada, 2012 to 2023

Figure 1: Notes

• Key years have been noted in the graph. They include:
  • Introduction of DAA (2014)
  • First broad access (2015)
  • Decreased cost (2017)
  • Universal coverage (2018)
  • Impact on services due to the COVID-19 pandemic (2020-2022)
• Data breakdowns by sex were not available for 2012 to 2017.
• Data for the 3 territories were not available, therefore national-level data only includes data from 10 provinces.

Figure 1: Text description

Provincial trends

Looking at provincial trends, we found that the size and timing of treatment peaks varied across the country. Most provinces reached their peak in 2018, while some did not peak until 2019. Treatment numbers declined in almost all provinces during the years most affected by COVID-19. Treatment numbers began to increase in some provinces in 2023. This may suggest the early stages of a post-pandemic recovery.

Figure 2: Estimated number of people treated for hepatitis C annually, by province, 2012 to 2023.

Figure 2: Notes

• Data were not available for the 3 territories.
• Data for 2012 to 2017 were not available for Prince Edward Island and Newfoundland and Labrador.

Figure 2: Text description and provincial data breakdown by sex (2018-2023)

Significance and next steps

Tracking trends in hepatitis C treatment helps us monitor progress toward eliminating it as a public health concern. By studying trends, we can observe patterns in the number of people treated and how they vary across regions. We need more data to report on progress and quantify each step people take towards getting diagnosed and treated (the care cascade). This includes the proportion of people with chronic hepatitis C who are treated. As a next step, using linked health and administrative data could help us understand access to treatment. Ultimately, this is necessary to optimize treatment access and help eliminate hepatitis C.

References

IQVIA disclaimer

The statements, findings, conclusions, views, and opinions expressed in this report are based in part on data obtained under license from IQVIA Solutions Canada Inc. concerning the following information service(s): GPM Custom Solutions from January 2017 to December 2023. All Rights Reserved. The statements, findings, conclusions, views, and opinions expressed herein are not necessarily those of IQVIA Solutions Canada Inc. or any of its affiliated or subsidiary entities.