13 October 2014 Last updated at 11:35 ET
By Reevel Alderson BBC Scotland's social affairs correspondent
More than 37,000 people in Scotland have chronic hepatitis C - but only half have been diagnosed
The NHS in Scotland could be reimbursed for the cost of a new hepatitis drug if sufferers fail to clear the virus.
The novel proposal was revealed after the drug Olysio was cleared for use by the Scottish Medicines Consortium (SMC).
The drug's manufacturer claims the move would help cut prescribing costs.
It is estimated Scotland wastes up to £44m each year on medicines for all conditions that are unused, ineffective or are taken incorrectly.
The 'Pay If You Clear' scheme would come into effect if patients treated with the drug do not become free of the hepatitis C virus (HCV) after 12 weeks.
SMC has approved the drug, whose generic name is simeprevir, for use within NHS Scotland. The 'Pay If You Clear' scheme is awaiting a formal decision by NHS Scotland.
Appropriate treatment
The drug will be used to treat patients with chronic HCV infection, including those for whom treatment has previously failed.
The manufacturer, Janssen, will pay for pre-treatment blood tests for patients to predict whether the drug is likely to be effective before treatment is initiated.
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End Quote Charles Gore Hepatitis C TrustWe must not forget the importance of prevention, earlier diagnosis and better testing strategies”
Any patient who does not respond to treatment within four weeks will be offered alternative therapies.
Dr John Dillon, consultant hepatologist and gastroenterologist at Ninewells Hospital in Dundee, welcomed the decision by SMC.
"This decision provides us with another treatment option which is convenient for patients and more affordable to NHS Scotland than some other treatments," he said.
"To be able to predict a person's response to treatment, prior to them embarking on the medicine, is a particularly useful factor in managing hepatitis C care.
"It means we can select the most appropriate treatment option in a cost-efficient manner."
Charles Gore, chief executive of The Hepatitis C Trust, said: "Decisions such as this from the SMC provide us with a key milestone for our campaign to eliminate hepatitis C.
"However, we must not forget the importance of prevention, earlier diagnosis and better testing strategies."
Charities claim there are more than 37,000 Scots with chronic HCV, only 55% of whom have been diagnosed, because often it has no symptoms.
Of those who develop hepatitis C an estimated 30% will develop cirrhosis of the liver or cancer.
Hepatitis C is the most common reason for liver transplants in Europe.
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