Yilian Patient Management System in Yunnan: A Digital Solution Accelerating Hepatitis C Elimination

Recently, the hit movie “Dying to Survive” has brought leukemia treatment into the public spotlight. As the prices of anticancer drugs such as Gleevec have been reduced and these medications have been included in the national medical insurance reimbursement list, the financial burden on patients with critical illnesses like leukemia and cancer is significantly alleviated.

However, in contrast to these severe, life-threatening conditions that can be fatal at any moment, certain insidious “invisible killers” have yet to receive adequate attention, with hepatitis C being a typical example. As World Hepatitis Day on July 28 approaches, hepatitis C remains largely outside the public spotlight.

The “low public awareness, low diagnosis rate, and low treatment rate” of hepatitis C is a widely recognized fact among many industry insiders.

It is understood that the prevalence of hepatitis C virus (HCV) infection in China is approximately 0.7%, corresponding to an infected population of around 9.8 million. However, by 2016, only about 1.17 million individuals had been diagnosed, accounting for less than 12% of all patients.

In contrast to the public’s intense fear of cancer, most people perceive hepatitis C as distant from their daily lives. The early symptoms of hepatitis C are subtle and difficult to detect. Moreover, patients are predominantly concentrated in remote rural areas where health awareness is low. Often, it takes 10–20 years for the condition to deteriorate into severe complications such as cirrhosis or even liver cancer before patients seek medical attention, by which time the optimal window for treatment has long passed.

Furthermore, the diagnosis of hepatitis C requires nucleic acid testing; however, county-level primary healthcare facilities often lack the corresponding testing capabilities, which is a major reason for the high rate of missed diagnoses.

Fortunately, hepatitis C is a curable disease. However, financial constraints remain a significant barrier preventing patients from accessing effective treatment. “Small advertisements for proxy purchases of generic drugs are frequently seen in hospitals,” reported a healthcare worker on the front lines of hepatitis C treatment.

In fact, the treatment landscape for hepatitis C differs significantly from that of leukemia. Can generic drugs truly replace originator drugs? In response to this question, a reporter interviewed Yue Wei, Deputy Director of the Department of Infectious Diseases at the First People’s Hospital of Yunnan Province.

Deputy Director Yue Wei, Department of Infectious Diseases, The First People's Hospital of Yunnan Province

Director Yue Wei pointed out: “Purchasing medications through proxy buyers not only carries the risk of obtaining counterfeit drugs, but also, given that hepatitis C has six genotypes, it is easy for such buyers to select the wrong medication. Furthermore, some patients discontinue treatment as soon as they observe initial effects, resulting in incomplete therapy. Others may experience adverse reactions; without medical guidance, they would be at a loss as to how to manage them. Therefore, we do not recommend purchasing medications through informal channels.”

Therefore, hepatitis C treatment must be sought at accredited medical institutions using originator drugs. To support impoverished patients, the China Primary Health Care Foundation and Gilead Sciences jointly launched the “Seeking Solutions to Cure Hepatitis C” assistance program earlier this year.

This project will cover more than 200 hospitals across 51 cities, initially benefiting over 4,000 hepatitis C patients with low-income or subsistence allowances. Patients receiving subsistence allowances can apply for free medication, while low-income patients (with an annual household income of less than RMB 150,000) can apply for a "buy three, get three free" assistance program.

Director Yue Wei introduced that among his patients, four recipients of subsistence allowances and more than 20 low-income individuals have applied for assistance.

The complexity of hepatitis C diagnosis and treatment imposes a significant burden on patients. It is reported that patients must visit hospitals five to six times, undergoing multiple tests from initial screening to final confirmation, with the subsequent treatment process being even more arduous. Moreover, as many hepatitis C patients reside in remote rural areas, the associated costs of transportation and accommodation for medical care are substantial. While financial assistance programs can help alleviate the high cost of medication, addressing the difficulty of accessing medical care is inherently more challenging. However, with the rise of internet technology, new innovations are quietly transforming traditional healthcare delivery models, offering fresh approaches to resolving the challenge of limited access to medical services.

In the “Seeking Solutions to Cure Hepatitis C” patient assistance program, Gilead’s strategic partner Medlinker, a leading domestic provider of medical solutions, leveraged its one-stop patient management services to establish a closed-loop service model encompassing remote follow-up consultations, e-prescriptions, and home delivery of medications, thereby addressing multiple pain points in the healthcare-seeking process.

Director Yue Wei believes that establishing patient records through the Medical Consortium Internet Platform has greatly facilitated physicians’ management of patients. Meanwhile, the internet platform has played a significant role in patient education and outreach, establishing effective communication channels between doctors and patients, thereby encouraging active patient adherence to treatment plans.

More importantly, it reduces the number of hospital visits for patients and alleviates their financial burden. Through Gilead’s patient assistance program, physicians can issue online prescriptions via the Medlinker platform, with medications delivered directly to remote areas. This not only facilitates clinical practice for doctors but also benefits patients. Furthermore, by using a compliant platform like Medlinker, patients can avoid the risk of purchasing counterfeit drugs.

Certainly, meeting the treatment needs of 9.8 million patients cannot rely solely on charitable organizations, caring enterprises, technological innovations, and medical institutions. It requires greater attention at the policy level and effective top-level design. Measures such as opening green channels for drug approval, shortening approval timelines, reducing distribution links, conducting state-led price negotiations, and including imported patented drugs in the national health insurance coverage will significantly improve the treatment challenges faced by hepatitis C patients in China.

Industry experts have repeatedly emphasized the urgent need to raise public awareness.

Since hepatitis C is primarily transmitted through blood, mother-to-child transmission, and sexual contact, there is an urgent need to encourage high-risk populations to undergo voluntary screening, while healthcare institutions must also take proactive measures. Currently, Director Yue Wei’s team has begun reaching out to grassroots communities to conduct screening and health education for high-risk groups, and is establishing an integrated prevention and control model encompassing screening, education, referral, treatment, and follow-up.

On the upcoming “World Hepatitis Day,” Director Yue Wei hopes that hepatitis C will receive extensive publicity and greater public awareness. “After all, hepatitis C is an infectious disease; if it does not receive sufficient attention, its societal harm can be substantial.”

According to the World Health Organization’s (WHO) 2030 goals for hepatitis C control—essentially eliminating the harm caused by hepatitis C—the screening rate among high-risk populations should reach 90%, and the treatment rate should exceed 70%. Achieving this goal remains a formidable challenge, requiring concerted and sustained efforts from all sectors, including governments at all levels, healthcare institutions, pharmaceutical companies, non-profit organizations, technology platforms, and news media.