The number of people with Hepatitis C in Italy is close enough to the world average of a little below 2% of the population according to figures released in 2015.
This means that about one million Italians have Hepatitis C and the genotype spread is similar to the rest of Western Europe and the USA with about 50% carrying HCV genotype 1, about 30% carrying Hep C genotype 3 and the remainder scattered between genotype 2 and genotype 4 with a small number of G5 and G6.
A very high number of Italians contracted Hepatitis C through tainted blood transfusions.
Like most European countries Italy has a reasonably good public health system and is committed to treating Italian citizens who are infected with Hep C. However like other health services throughout Europe it is not possible for Italy’s Health Service to find the extraordinary amount of money demanded by pharmaceutical companies like Gilead to treat all Italian’s with Hepatitis C.
The maths is simple. For treating genotype 1 Gilead wants more than 50,000 Euros per treatment for Harvoni or Epclusa. So to the treat the more than one million Italians with Hep C it would cost the Italian health system more than 50,000,000,000 Euros; an impossible amount.
So as with other Health services in Europe the Italian government triages their Hepatitis C patients and only the sickest can access treatment through the Italian health system.
One of the interesting things about Italy that I have noticed is that Italian doctors are generally more supportive of their patients doing the generic Hep C treatment however the Italian medical "Establishment" and the Italian National Health Service is not supportive of generic treatment.
Nor is the Italian Customs Department.
This means that those who are not sick enough to access treatment through the public health service must either wait until they get sick enough to get government treatment or seek an alternative to the government treatment, which is obviously to use generic Hepatitis C medication from India or Bangladesh.
The problem for Italians is that the Italian Customs is not permitting Italians with Hepatitis C to import generic medicines for person use. If generic Hep C medication is shipped to Italy then the Italian Customs will seize it and either destroy it or return it to the sender.
I have tried many different ways of sending Hep C medication direct from India to Italy and all attempts have failed.
However there are ways for Italians to get generic Hepatitis C treatment.
The simplest is if they have friends or family in the UK because the UK has very favourable rules for its residents and allows the importation of medicine for personal use without a prescription. This method is safe and also legal whilst the UK is still in the EU however once the UK leaves the EU this door will close.
So many Italians either fly to the UK and have the generics sent to them there or have the generics sent to friends in the UK who then simply mail the medicines to Italy.
Because mail between the UK and Italy is treated as “internal mail” it not subject to the same level of Customs inspection as parcels from places like India and all shipments sent from the UK to Italy this way have been successful.
Of course Italians can also fly to India and buy their Hep C meds there and return home. It is completely legal to do this but it is expensive and time consuming.
So far all this is rather similar to many other European countries where the governments enforce rules that favour the big pharmaceutical companies to the disadvantage of their own citizens and indeed their own national economies.
However what is unique about Italy is that the Italian constitution guarantees the right of Italians to good health. The Italian Constitution specifically states that Italians have “a right to good health.”
Article 32 of the Italian Constitution:
"The Republic safeguards health as a fundamental right of the individual and as a collective interest, and guarantees free medical care to the indigent.
No one may be obliged to undergo any health treatment except under the provisions of the law.
The law may not under any circumstances violate the limits imposed by respect for the human person."
This means that when the Italian Customs officials seize medicines that are the only way that the person can regain good health then the official and the Customs Department are actually breaking the Italian Constitution by denying the Italian citizen access to their right to good health.
So we have a government department in breach of the Italian Constitution and no-one in Italy is doing anything about it… well that is not entirely true because there are some people in Italy who are going to do something about it, and very soon!
But that is another story, a story at is unfolding as I write