Clinical Commissioning Policy Statement: Treatment of chronic Hepatitis C in patients with cirrhosis

2015 NHS England B07/P/a, NHS Technology Adoption Cente

"POLICY STATEMENT: Treatment of chronic Hepatitis C in patients with cirrhosis Commissioning position: The regimens set out in the table below will be commissioned as an alternative to current therapies when the following apply: For patients with compensated cirrhosis:
1) Treatments are provided to the NHS under a commercial-in-confidence scheme AND
2) The patient has compensated cirrhosis defined as:
- Evidence of portal hypertension without other obvious cause (e.g. varices on endoscopy or previous ascites in the absence of vascular lesions known to cause portal hypertension), OR
- APRI score and AST:ALT ratio indicative of cirrhosis (APRI >2.0 with an AST:ALT ratio > 1), OR
- Imaging (Ultrasound or CT or MRI) reported as showing cirrhosis. OR
- Fibro Scan or liver elastography showing evidence of cirrhosis (for example, a Fibro Scan score of >11.5kPa, or as determined by an expert panel if required), OR
- Liver biopsy showing cirrhosis [...]"