Subject: RE: Report April
From: "Sopo Belkania" <Belkania>
To: Graeme Robertson <[email-masked]>
Cc: Aysan Murtezaoglu <[email-masked]>; Sean Barr <[email-masked]>;Maia Lagvilava;
Date: Tue, 15 May 2018 14:00:21 +0300

Dear Graeme,

Hope you are doing well!

Firstly, let me introduce you with Mrs. Maia Lagvilava, Deputy Minister who joined our team few months ago and is now responsible for the Hepatitis C Program. I have cc-ed here in this correspondence and please kindly include or address her in future Hepatitis C Program related communication.

 Secondly, regarding your request, let me briefly describe the current situation:	
As you are aware, from the beginning of the program implementation more than 46 000 HCV patients were registered, more than 45 000 out of registered patients have already started treatment and more than 40 000 have completed treatment. 
Patients flow within the HCV Elimination Program is being gradually changed. Recently, gradual decrease of patients’ inflow in the treatment component have been observed. According to our preliminary analysis, the decrease of the patients’ inflow is caused by several reasons, including financial and geographical barriers.

At this stage, the Ministry of Labour, Health and Social Affairs of Georgia is working on the activities to scale up HCV Elimination Program throughout the country from June or July 2018, by establishing minimum one HCV service provider in each municipality and cities of local governance. Primary healthcare facilities will be involved in HCV Elimination Program to deliver comprehensive services within diagnostic and treatment components, including 10 PHC facilities in Tbilisi, 2 in Kutaisi, 2 in Batumi and 1 in Zugdidi. In total, 84 centers will be involved in HCV program implementation which will ensure geographical access as much as possible.  Implementation of the decentralization project significantly depends on introduction of the Sofosbuvir/Velpatasvir, as more simplified and cost-effective regime of HCV treatment (no additional medication is required). In particular, at this stage, the total cost of diagnostic tests for treatment uptake (including genotype, ultrasound research, elastography, etc.) equals 369 GEL / 147.6 $, out of which patient’s co-payment is 258.3 GEL / 103.3 $, in case of treatment with Pangenotipic medicines, diagnostic algorithm will be significantly simplified and the total cost of diagnostic tests will be about 230 GEL / 92 $ and co-payment about 160 GEL / 65 $. 
We believe that this intervention will significantly increase the patients’ involvement in the program (About 1500-2500 patients per month).
In addition, we are actively discussing the issue to launch the program on the territory of Autonomous Republic of Abkhazia, that will enable us to use Harvoni remained on the balance of the Ministry for the treatment of patients living on the territory of Abkhazia.
We would highly appreciate if you could consider the possibility of delivering Sofosbuvir/Velpatasvir.  In case of your consent, with great pleasure, we will make a new order and determined the necessary quantity of the drug.

Best regards,

Sopo Belkania 
Head of HR Management and International Relations Department
Ministry of Labor, Health and Social Affairs of Georgia
144 A.Tsereteli Avenue, 0159, Tbilisi, Georgia
Mobile number: +995 599 22 32 32

-----Original Message-----
From: Graeme Robertson [mailto:[email-masked]] 
Sent: Friday, May 4, 2018 1:11 PM
To: Sopo Belkania
Cc: Aysan Murtezaoglu; Sean Barr
Subject: Re: Report April

Dear Sopo

Please could you kindly provide an updated supply / Shipping forecast so we can ensure timely supply of Harvoni. Specifically what date will you need the next shipment of Harvoni Thank you for the update Best wishes

Graeme

Sent from my iPhone

> On 2 May 2018, at 08:53, Sopo Belkania <[email-masked]> wrote:
>
> Dear Graeme and Aysan,
>
> Hope this email find you well.
>
> Please find attached report for April month.
>
> Best regards,
>
> Sopo Belkania
> Head of HR Management and International Relations Department Ministry 
> of Labor, Health and Social Affairs of Georgia
> 144 A.Tsereteli Avenue, 0159, Tbilisi, Georgia Mobile number: +995 599 
> 22 32 32
>
>
>
>
> <Report April_2018.doc>
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