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Health authorities were refusing to fund alpha interferon due to its cost and belief it was of limited clinical effectiveness.

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Ribavirin combined with interferon increased cure rates of Hepatitis C significantly.

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Interferon-free treatments became available. These were a combination of sofosbuvir and other agents which "ensured high treatment rates were achievable" without the use of interferon.

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The Expert Group on Hepatitis explained that the major factor determining any long-term impact of Hepatitis C on a person's health is the degree of liver fibrosis at the time when the Hepatitis C polymerase chain reaction ("PCR") test became negative.

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Interferon was used in the UK to treat poor liver function prior to its licensing in 1994.

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In a memo regarding a pilot study of Hepatitis C screening, John Canavan noted that additional treatment costs "could be very substantial indeed" if interferon were to become the established therapy for Hepatitis C carriers.

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Dr Bell, Consultant Gastroenterologist at Ipswich Hospital, sought advice from the CMO regarding funding for interferon treatment. He reported that the District Health Authority had described the funding for the treatment as a "grey area".

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The West Midlands Director of Public Health wrote to the Deputy CMO to say that about 300 patients infected through transfusions were expected to be identified through the Hepatitis C lookback, with potential treatment costs of £500,000, and asked "who is going to pay."

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The Deputy CMO stated that "patients on interferon require frequent monitoring of their blood count and biochemistry. For these reasons therefore it would be usual for hospitals rather than GPs, to prescribe Interferon. If they decide that this is what [is] required clinically, then the patient's Health Authority [or] GP fundholder, as purchasers, will then have to consider whether or not to fund the treatment having regard to their priorities."

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Graham Barker of the Haemophilia Society wrote to the Department of Health to say that "the Society believes that the provision of interferon alpha for the treatment of HCV should be centrally funded."

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At a meeting of regional haemophilia centre directors Dr Brian Colvin said he "knew of problems in funding interferon and he thought that the Department of Health should confirm that this treatment would be funded when recommended by a physician."

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The British Liver Trust, Haemophilia Society and Mainliners sent a letter to the Secretary of State, Stephen Dorrell, saying they were particularly concerned that significant numbers of people infected with Hepatitis C, were not getting access to "treatment with Interferon or other drugs".

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The haemophilia centre directors met. Dr Frank Hill reported that it was "an on-going battle to persuade purchasers to pay for [interferon treatment]." It was proposed at the meeting by Dr Brian Colvin that Dr Andrzej Rejman, a senior medical officer at the Department of Health, be contacted if haemophilia centre directors encountered difficulties.

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Graham Barker of the Haemophilia Society continued to highlight instances of interferon treatment being denied on the grounds of cost.

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The Department of Health replied to Graham Baker, to say that it did not hold back money centrally or allocate resources to support specific treatments for particular segments of the population and that purchasers in local authorities were responsible for assessing the health needs of local residents.

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Professor Howard Thomas wrote to the Department of Health to report difficulties of funding for interferon treatment.

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The Department of Health replied to Professor Howard Thomas maintaining the policy line that purchasers in local authorities were responsible for assessing the health needs of local residents.

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Dr Hugh Nicholas, a senior medical officer in the Department of Health, expressed concern that the allocation of resources for the treatment of Hepatitis C may be "very patchy" across the country.

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The Department of Health wrote to the Haemophilia Society that the cases it, and the UKHCDO, had raised had been investigated, and the relevant health authorities and trusts had reported to it that interferon had now been provided.

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The British Liver Trust released a press release noting that treatment, counselling and support services for Hepatitis C were inadequate according to a survey of liver units.

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