How Is The Treatment Done
The hepatitis B treatment depends on how far the virus has spread in your body and how much damage your liver has undergone. The treatment also depends majorly on how free your body is from other chronic medical ailments. The best treatment that can ultimately curb the virus from becoming active in your body is to take the hepatitis B vaccine. Also, you really have to be careful, and you should avoid from getting an unprotected sex. Also there more chances of you getting the infection from sharing the needles with your drug partner. The virus strain can be either acute or chronic. For the acute cases, you might not need any medications. You have to change your dietary patterns, and you have intake a lot of fluids. However, you have to go for regular visits to your doctor to check for the activeness of the virus. In chronic cases, you may have to depend on medications, and these can be for an extended period. The medications act differently for every individual, and there is no specific time limit for getting cured. In advanced cases when your liver is beyond repair, a liver transplant might be the only solution, and even that cannot be possible for many individuals.
Are The Results Of The Treatment Permanent
Once you are vaccinated, you will not have a chance of getting the virus. For others who have undergone the treatment options, you would not have the symptoms again, but still, the damage to your liver in some cases can be permanent. It depends on how far the virus has affected your liver and how your body has responded to the treatment.
Hepatitis B And C Can Be Wiped Out In The Us By 2030 Heres How
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Health experts have devised an aggressive plan to stamp out a viral disease that is fueling a sharp rise in liver cancer in the United States and killing 20,000 Americans per year.
Their national strategy for eliminating two types of hepatitis by 2030 hinges on persuading the federal government to purchase the rights to one or more of the costly new medications that can essentially cure hepatitis C.
That unprecedented step is one of a raft of recommendations issued Tuesday by the National Academies of Sciences, Engineering, and Medicine. The academies expert panel also recommended a campaign to vaccinate all adults against hepatitis B, expanding needle exchanges for intravenous drug users and a nationwide effort to identify and treat the legions of Americans who are unknowingly infected with either strain of the virus.
All these efforts should be coordinated by a single federal office, the panel proposed.
With about 2.7 million Americans infected with hepatitis C and 1.3 million people infected with hepatitis B, the stakes are high. A 2009 report estimated that the annual cost to Medicare of caring for hepatitis C patients alone would increase from $5 billion in that year to $30 billion in 2030. And that forecast didnt include a new generation of expensive drugs.
There are times when the government must act to correct a market failure, the panel wrote.
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We Are Going To Beat This
In Tias case, Bordon ran the requested tests. He filed an appeal with the insurance company providing Tias Medicaid coverage.
This is crazy, Tia said as she waited to hear if she would be covered. I called back again and again. How can an insurance company say theyll only cover one treatment in a patients lifetime?
Because she had developed some cirrhosis, a board finally determined she was eligible to receive a second round of treatment. She was sick enough to qualify for Vosevi, a combination of three hepatitis C drugs thats approved for cases like hers.
She started taking it in April and is feeling optimistic. I am hoping my liver will regenerate, she said.
Bordon said indications are that Tias will, and the medication is knocking down the virus, he said. Shell be taking the pills for three months.
Two weeks in, Tia had good news. The virus is almost undetectable, she said.
I feel good, she added. I have a plan. We are going to beat this.
Update: As of July 20, after six weeks of treatment, a blood test could not detect any hepatitis virus in Tias blood.
How Much Is Hepatitis C Drugs Pricing Disclosure Outside Insurance
2. Hepatitis C medications are expensive Antiviral medications for hepatitis C are highly effective, but come at a high price. Just one Sovaldi medication costs $1,000. A 12-week treatment session with this medication costs $84,000. Other hepatitis C medicines are likewise expensive: A 12-week therapy with Harvoni costs $94,500.12-week therapy with Mavyret costs $39,600.
Zepatier therapy costs $54,600 for 12 weeks Treatment with Technivie costs $76,653 for 12 weeks. Drugs for hepatitis C are expensive due to their great demand and the high price of bringing them to market. Developing a new treatment, testing it in clinical trials, and selling it can cost almost $900 million for pharmaceutical corporations.
The absence of a national health care system to negotiate prescription rates on behalf of customers also contributes to the high cost. Also, there is limited rivalry from other pharmaceutical businesses. Consequently, hepatitis C medicine producers may charge practically whatever they want.
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Who Is Not Eligible For The Treatment
The treatment depends on how severe the condition is and how far the virus has spread in your body. The antiviral medicines suitable for one body type may not be suitable for the other individual. Have a detailed evaluation with your doctor and look for the symptoms. If you are suffering from other chronic medical conditions, you might not be a suitable candidate to take these medications.
Study Design And Study Population
Two retrospective cohorts of outpatients and inpatients were created using the electronic medical records from the hospital information system of the Guangzhou Eighth Peoples Hospital, the largest specialized infectious disease hospital in Guangdong Province, China. This cohort included inpatients and outpatients with HBV related conditions including CHB, cirrhosis and HCC during the period from January 1, 2008 to December 31, 2015, who were identified according to the International Classification of Disease, 10th Revision codes . Patients co-infected with hepatitis A, hepatitis C, hepatitis D, hepatitis E, HIV or cytomegalovirus were excluded from this study. Patients admitted to the hospital due to pregnancy or other diseases including glomerulonephritis, uremia, metabolic syndrome, tumor, sever cardiovascular diseases were also excluded.
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What Are The Post
The post treatment guidelines are very much mandatory when undergoing the medications. You need to make lots of changes to your lifestyle and in most cases your eating habits. Technically your care for your liver should double, and you might not want to indulge in any activity that can hamper your liver again. You have to ultimately curb your smoking and drinking activities and refrain from using drugs. Also, the medications have to be taken religiously and should never be skipped.
Direct Nonmedical And Indirect Costs
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Accessing Hepatitis B Treatment
Globally, almost 300 million people are living with hepatitis B. Of these 300 million people, the highest burden is in the WHO Western Pacific region and WHO African region with 116 million people and 81 million people living with hepatitis B. 60 million people are infected in the WHO Eastern Mediterranean Region, 18 million in the WHO South-East Asia Region, 14 million in the WHO European Region and 5 million in the WHO Region of the Americas.1
Of these estimated 300 million people living with hepatitis B, only 10% were diagnosed, and of those who were diagnosed, only 22% of individuals eligible for treatment received antiviral therapies.2 Moreover, only 2% of Africans living with chronic hepatitis B infection receive a diagnosis and of those individuals, 0.1% receive treatment.3
So why arent people living with hepatitis B on treatment? Cost can be a barrier.
The Hepatitis B Foundation compiled a list of hepatitis B medications and their costs for a 30-day supply in the U.S.
In the U.S., if someone does not have insurance or know how to access Medicaid or Medicare, they might not be able to afford medication. If they were to pay out of pocket, medication would total $11,484 on the low end of costs.4 One study reported that low household income and publicly funded health insurance were negatively associated with willingness to accept hepatitis B treatment.5
What can be done to help with cost for hepatitis B treatment?
Apply For Patient Assistance Programs
Another option is patient assistance programs.These are sponsored by pharmaceutical companies and give those in low-income households access to medications.
Keep in mind that youre only eligible for patient assistance programs if you arenot enrolled in Medicare, Medicaid, or another government prescription plan. These programs provide financial assistance, reducing your copays and coinsurance for medication.
Assistance varies, so youll need to contact drug companies directly to learn about their specific programs. Some examples include:
The National Viral Hepatitis Roundtable also provides information on getting financial assistance or copay relief.
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Patent Expirations Will Help
While it is potentially very inexpensive to manufacture generic ETV, current prices of the drug are unfortunately very high, with a lowest global price of US$427 for a generic version not approved by a stringent regulatory authority such as the U.S. Food and Drug Administration, and US$6,127 for a generic version sold in the United States. This is because use of entecavir is currently very low, due in part to the very high prices of branded ETV and TDF, which have to some degree limited the uptake of these drugs in middle- and high-income countries . However, patents on ETV have recently expired in much of the world, including in the United States, and TDFs main patents will have expired by 2018 in most countries. This will create a dramatically different situation, as it should enable patients throughout the world to receive the most effective treatments while also making it economically feasible to explore the provision of treatment earlier in infection using a simplified public health approach.
You Have More Treatment Options Than Ever Before
More than a dozen treatments are available to treat hepatitis C. Older drugs still used include:
- peginterferon alfa-2a
Which of these drugs or combinations of drugs your doctor prescribes depends on:
- your virus genotype
- the extent of your liver damage
- which other treatments youve had in the past
- what other medical conditions you have
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The state is also facing a shortage of doctors who both prescribe hepatitis C drugs and treat Medicaid patients, making it very difficult for people living in rural areas to access care. In certain areas of the country, like Natchitoches Parish on the western border of the state, the nearest clinic is either 50 miles south in Alexandria or 70 miles north in Shreveport, according to the states own database of providers. Patients living in the parishes on the eastern border, like Madison, likewise would have to travel nearly 50 miles to the city of Monroe to see a doctor.
I see patients from hours away sometimes that are driving here to find someone to treat hepatitis C, Richey said.
Louisiana also had plans to set up a training program, dubbed HCV Champions, to get doctors familiar with treating hepatitis C. It set a goal of having one hepatitis C treatment advocate in each of the states nine public health regions. But the state doesnt appear to have reached that modest goal either.
Experts STAT spoke to emphasized that Louisianas slowing progress could be explained by the fact that the state had a backlog of people awaiting treatment in the early rollout, but now, its harder to find people to treat.
Your Insurance Company Could Say No
Some insurance companies try to combat the high cost of hepatitis C drugs by rejecting coverage for them. More than one-third of people were denied coverage for these drugs by their insurance company, according to a 2018 study in Open Forum Infectious Diseases. Private insurance companies rejected more claims for these drugs over 52 percent than Medicare or Medicaid.
Medicare and Medicaid are more likely to approve hepatitis C drug coverage. But with Medicaid, you might have to meet certain requirements to receive these drugs, such as:
- getting a referral from a specialist
- having signs of liver scarring
- showing proof that you have stopped using alcohol or illicit drugs, if this is a problem
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How Long Does It Take To Recover
The recovery period depends on how much the virus has affected your liver and how far your body has cooperated with the antiviral drugs. For some, the results of the treatment can be immediate, but for others, it can be long term. The antiviral drugs may also not work across for some sections of people. Consult with your doctor about these implications and the recovery period.
Cost Of Illness Of Chronic Hepatitis B Infection In Vietnam
- Unit of PharmacoEpidemiology and PharmacoEconomics , Department of Pharmacy, University of Groningen, Groningen, The NetherlandsDepartment of Pharmaceutical Management and Policy, Hanoi University of Pharmacy, Hanoi, Vietnam
- Shu Chuen LiCorrespondenceAddress correspondence to: Shu Chuen Li, Discipline of Pharmacy and Experimental Pharmacology, School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia ContactAffiliationsDiscipline of Pharmacy and Experimental Pharmacology, School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
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Measurement Of Direct Nonmedical And Indirect Costs
Estimation of prevalence
Liver Int.
Liver Int.Asian Pac J Cancer Prev.Asian Pac J Cancer Prev.Asian Pac J Cancer Prev.
Sensitivity analysis
J Gastroenterol Hepatol.Trans R Soc Trop Med Hyg.Trans R Soc Trop Med Hyg.
Am J Trop Med Hyg.Aliment Pharmacol Ther.J Gastroenterol Hepatol.Am J Gastroenterol.Liver Int.
The Patient Advocate Foundation
This organization provides copay relief and a directory of national and local resources that can offset some of the financial burden of medical expenses.
Whatever the cost, the benefit to the person to eradicate hepatitis C today and not deal with complications is immense, says Joseph Galati, MD, medical director for the center of liver disease and transplantation at Houston Methodist Hospital.
The average person may not appreciate the savings from preventing somebody from getting liver cancer or a liver transplant or the disability associated with chronic hepatitis C, says Dr. Galati. Whatever the cost for treatment is, its a drop in the bucket when you look years down the line as far as the potential cost of living with hepatitis C.
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You May Not Need Treatment
Not everyone with hepatitis C will need to receive these expensive treatments. In up to of people with hepatitis C, the virus clears on its own within a few months without any need for medication. Your doctor will monitor you closely to see if your condition persists, and then decide if you need treatment.
General Characteristics Of The Study Population
A total of 65,175 outpatients and 12,649 inpatients were retrieved from the Guangzhou Eighth Peoples Hospital database for the study period between January 1, 2008 and December 31, 2015 . General characteristics of the outpatients and the inpatients by disease stages were detailed in Table . Approximate 90% outpatient visits and 57% inpatients admissions were due to CHB, 9% and 27% were due to cirrhosis, and 1% and 16% were due to HCC. About 75% of these patients were male and the proportion of patients aged 40 to 60 accounted for approximately 50%. Self-payment and medical insurance were the main payment modes. Table also shows the proportions of patients received prescriptions for antiviral drugs, hepatoprotective drugs, traditional Chinese medicine and anti-fibrotic medicine for outpatients and inpatients.
Fig. 1
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