EXPAND-C: hepatitis C testing and treatment through community pharmacies

Burnet is working with community pharmacists to make it easier for the 74,000 Australians living with hepatitis C to access testing and treatment. In doing so we are evaluating a community-focused method of delivering healthcare.

Pharmacists are trusted members of the community, and this project recognises their vital role in supporting public health initiatives. By working closely with pharmacists and prescribers, the project aims to make hepatitis C testing and treatment easier to access for people who may not regularly visit a doctor or feel comfortable discussing hepatitis C.

Selected as one of the first projects funded by Burnext in 2024, the 2-year project builds on previous work done by Burnet. EXPAND-C will focus on offering information, counselling, testing, and referral to treatment to people at risk of hepatitis C in pharmacies across Victoria.

Evaluation of the project will provide information about how this model could be applied to other public health testing campaigns within community pharmacies. The project highlights the important and expanding role of community pharmacists and acknowledges them as valuable members of the public health team.

About EXPAND-C

EXPAND-C aims to reach individuals at risk of hepatitis C, which is a bloodborne virus that is transmitted through exposure to the blood of a person who already has it. 

Everyone who is eligible and consents to participate will be offered an INSTI® rapid point of care hepatitis C antibody test, with results available within 1 minute. Follow up blood testing will be done at the same visit by the project nurse if indicated. 

The EXPAND-C project team will deliver and evaluate this model of providing hepatitis C testing by a nurse situated in community pharmacies. It will not be evaluating the effectiveness of any testing device or drug.  

Anyone requiring treatment will be referred to a healthcare practitioner to receive a prescription for PBS-listed hepatitis C treatment. 

EXPAND-C supports the World Health Organization’s goal of eliminating hepatitis C by 2030.

How it works

Pharmacists who take part in the study will offer hepatitis C harm minimisation information to their clients coming in for OAT and, if they would like to know more, connect them with the project nurse to discuss involvement in the project.

The nurse will explain the project requirements and procedures and obtain informed consent for rapid testing with the INSTI® point of care hepatitis C Antibody test. The INSTI ® point of care hepatitis C Antibody test provides results in just 1 minute and will show whether a person has ever been exposed to hepatitis C. It doesn’t confirm current active infection. 

If the INSTI® point of care hepatitis C Antibody test detects antibodies, the study nurse will offer on-the-spot blood testing to confirm infection status and complete any necessary pre-treatment checks. They will also discuss results and arrange a treatment plan for anyone who needs it.

Project aims

EXPAND-C aims to:

• increase access to fast and convenient testing services for people at risk of hepatitis C
• offer harm minimisation information and treatment referral options
• make access to public healthcare interventions easier for those people who may not regularly visit a GP or health service
• recognise the trusted relationships community pharmacists have with their customers  
• strengthen connections between pharmacists and other members of the public healthcare team
• reduce the burden of illness within the community and the associated cost of hepatitis C-related liver disease on the healthcare system
• improve health outcomes for people with hepatitis C.

Key activities

Some of the key activities will include:

• placing hepatitis specialist nurses in community pharmacies that have customers taking opioid replacement therapy
• offering hepatitis C counselling, testing, and treatment pathways within pharmacies for people at risk for hepatitis C transmission
• evaluating how well this model works to improve hepatitis C diagnosis and treatment rates
• evaluating the model's cost-effectiveness and whether or not it can be adapted to screen for other infectious diseases in the future.

The future of healthcare is community-based

EXPAND-C aims to expand existing healthcare options for people by acknowledging community pharmacists as important members of the public health team. Pharmacists are perfectly placed to facilitate screening and referral to care for treatable conditions such as hepatitis C.

EXPAND-C follows the National Preventative Health Strategy 2021–2030 and the Sixth National Hepatitis C Strategy 2023–2030 by helping to build a stronger healthcare network and offer ease of access for people to primary healthcare interventions.

It’s a step toward making healthcare fairer, easier to access, and more sustainable.