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Even though health insurance can be expensive, your monthly premium through an employer might be considerably less than the cost of treating hep C without it. If thats not an option, you can research coverage options on the U.S. Health Insurance Marketplace during open enrollment periods.
Keep in mind, though, even with private or individual health insurance, your provider might not cover the cost of hep C treatment until youre very sick, and only if you dont use drugs or alcohol. Be sure to find out all you can about your coverage before applying.
Theme : Suboptimal Acceptability Of Treatment
Limited disease awareness and treatment adherence
Although DAAs were claimed to be very effective and highly appreciated , a public health officer found that people living with HCV still generally knew very little about the disease, let alone the fact that it was curable. A general medical officer also admitted that he had a hard time convincing some of them to receive a screening test. Moreover, it was emphasized that the consequences of non-adherence to treatment must be reiterated , especially to those who were found to misplace their medications , skip doses , turn up late for follow-up , and continue substance use .
The suboptimal uptake of HCV screening and treatment was also partly attributed to the stigmatization of the disease. The public often related HCV to drug abuse , and some patients had been hesitant about receiving treatment to avoid discrimination . Apart from that, the lack of sensitivity to the feeling of patients and the tendency to be judgmental about how they contracted HCV in some less experienced care providers might have unintentionally triggered treatment rejection.
What Is Hepatitis C
Hepatitis C is a blood-borne virus which, if left untreated, can cause liver cancer and liver failure.
It usually displays no symptoms until the virus causes enough damage to bring on liver disease.
Symptoms may include fatigue and difficulty concentrating and the virus is also linked to cardiovascular disease, mental health issues, kidney disease and musculoskeletal pain.
The project has helped find and cure 70,000 people of the potentially fatal disease and reduced the number of people seeking liver transplants due to the virus.
Within six years, the number of people seeking liver transplants due to the virus fell by two-thirds.
The number of annual registrations for a liver transplant in patients with Hepatitis C-related diseases also dropped from fewer than 140 per year to fewer than 50 per year in 2020.
The project has also provided 80% of its treatments to people from communities in the poorest half of the population.
An NHS screening programme launched in September is enabling thousands of people unknowingly living with Hepatitis C to get a diagnosis and treatment sooner by searching health records for key risk factors, such as historic blood transfusions or those with HIV.
Hepatitis C Trust chief executive Rachel Halford said the charity is delighted to be a part of this unique elimination deal to help find, test and treat people most at risk of contracting hepatitis C.
She said: The progress that has been made towards elimination is truly astounding.
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Theme : Limited Access To Health Facilities
Movement restrictions during coronavirus disease 2019 outbreaks
Malaysia had been hard-hit by the COVID-19 pandemic for almost a year at the point of the study. Intermittent travel restrictions, or formally known as movement control orders, were consistently cited as the key reason of HCV patients not seeking treatment and defaulting on their clinic appointments . After observing a series of lockdowns, a gastroenterologist also highlighted that the condition was even more challenging to those who were tested positive for anti-HCV elsewhere and needed to travel far to health settings for treatment. The prohibition of vehicle sharing , coupled with the fear of COVID-19 , further discouraged people living with HCV from care seeking. As simplifying HCV care became more relevant than ever, a family physician perceived that a lot more efforts could be put into integrating HCV testing and treatment with other health services in response to the ongoing pandemic.
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The health department, I hope, will be stepping up efforts to increase testing, awareness, and clinician capacity for treatment of the virus that needs to ramp back up, Gee said.
She said the department needs to increase staffing, to make clear to people in the department that this is a priority and to ensure that there’s an adequate evaluation of the programs progress if they want to see the state get back on track.
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Pregnancy And Hepatitis C
The new hepatitis C medicines have not been tested in pregnancy.
You should not become pregnant while taking treatment as it could be harmful to unborn babies.
If you’re pregnant, you must delay treatment until after your baby is born.
Speak to your doctor before starting hepatitis C treatment if you’re planning to become pregnant in the near future.
You’ll need to wait several weeks after treatment has ended before trying to get pregnant.
Women taking ribavirin should use contraception during treatment and for another 4 months after the end of treatment.
If you become pregnant during treatment, speak to your doctor as soon as possible to discuss your treatment options.
Treatment Coverage And Drug Expenditure In Hepatitis C Patients From 2013 To 201: A Journey Of Improving Treatment Accessibility In Malaysia Through Government
Muhammad Radzi Abu Hassan 3
how to cite: Chan H, Hassali M A, Md Said R, Abu Hassan M R . Treatment Coverage and Drug Expenditure in Hepatitis C Patients From 2013 to 2019: A Journey of Improving Treatment Accessibility in Malaysia Through Government-led Initiatives. Hepat Mon. 2020 20:e107372. doi: 10.5812/hepatmon.107372.
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Already, advocates are warning the White House that it needs to focus on small-scale interventions, like supporting needle exchange programs, making sure doctors can get reimbursed for so-called street medicine and investing in peer-navigators that help people get connected to care.
Collins said in an interview that the White House is learning from Louisiana, Washington, and other hepatitis C elimination efforts. He also shed light on further aspects of the program, like developing faster tests for the virus, that he says will help the federal government identify and treat hard-to-reach infections.
But he also emphasized the challenge of achieving the ultimate goal of eliminating hepatitis C.
This is going to be really hard. If it wasnt really hard, it probably would have just happened by now, Collins said. Were going to eliminate hepatitis C not because its easy, but because its hard.
When Washington and Louisiana set out on their effort to eliminate hepatitis C, a course of treatment could run as much as $94,500 even now, the medications retail for roughly $24,000 for a cure.
The deals, which provided drugs for Medicaid beneficiaries and people in the states prison systems, seemed like a genius way to get the miracle pills to the people who needed them the most.
Their ultimate goals were similar: Washington pledged to cure 80% of the people in the state by 2030. Louisiana gave itself until 2024.
Hepatitis C Treatment Estimates
Today, the Centers for Disease Control and Prevention released data on the first estimates of hepatitis C treatment, from 2014-2020, using data from a national prescription claims database, IMS Health & Quintilesexternal icon . The treatment estimates were presented at this years virtual American Association of the Study of Liver Disease meeting as a poster titled Hepatitis C treatment in the United States, 20142020 by Eyasu Teshale, MD, Division of Viral Hepatitis, CDC. The poster reported on the estimated number of people initiating hepatitis C treatment from 2014 to 2020 and summarized the characteristics of persons infected with hepatitis C who were treated in the United States with direct-acting antiviral agents during that same time period.
The study found that over the six years of the study, approximately 843,000 people with hepatitis C in the United States initiated treatment with DAAs, an average of 120,000 people treated each year. The number of people treated was highest in 2015 with 164,247 people treated, and then declined to its lowest level in 2020 with 83,740 people treated likely due to COVID-19-related disruptions to hepatitis C testing and treatment, and continued restrictions on coverage of HCV treatment by some insurers.
Additional select findings from the study include:
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Hcv Treatment Provides Good Value
Despite its cost, HCV treatment provides good value for the money, as expressed in terms of cost-effectiveness. In a recent review, Linas and Nolen note that most studies in the past five years find that HCV treatment falls within the generally accepted value of $100,000 per quality-adjusted life year . They note that these studies do not reflect price decreases that have occurred in the past 1-2 yearsbut the substantial cost burden remains. A critical question is not whether to treat patients with HCV, but when, because of the significant lag time between infection and disease. Facing costs that could overwhelm fixed budgets, many payers have restricted treatments to those with advanced disease or those who are alcohol- or drug-free.
There is some evidence that public payers are relaxing their eligibility restrictions for hepatitis C treatment. Kapadia, Jeng, Schackman, and Bao looked at Medicaid drug utilization data from 2014 to 2016, and found that states that loosened their restrictions had a more rapid increase in prescriptions of direct-acting antivirals than states maintaining their restrictions. The 31 states that implemented Medicaid expansion under the Affordable Care Act saw much more of an increase in utilization than states that did not.
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Q: Who Is At Risk Of Contracting Hcv
A: Following type of people are at risk of contracting Hepatitis C-
- People who use injectable drugs
- People with HIV
- People receiving kidney dialysis for long
- Children of an infected mother
- People born between 1945 and 1965
- People who have got piercings or tattoos
- Healthcare workers who handle blood
- Patients with diseases that require blood from donors
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Theme : Gaps In Hcv Treatment Delivery
Limited staffing and capacity
Public health settings generally did not face a workforce shortage, especially after more and more general medical officers were stationed in PHC centers and hospitals . In contrast, health services in prisons and drug rehabilitation centers were run by small medical teams appointed by the Ministry of Home Affairs. Understaffing and multitasking were cited as the major challenges in performing HCV screening and linking those with a positive test result to care in correctional settings. A medical practitioners shared his experience as follows: I served in a prison with more than 3,000 people, but there was only a small medical team of three doctors and three assistants. We were obliged to manage a wide range of complicated illnesses, including mental illnesses. A family physician commented that resource sharing between ministries, such as by sending visiting physicians from PHC centers to assist prisons and drug rehabilitation centers, would have alleviated the problem. However, she added that such an attempt was often limited by a strict protocol to receive external care providers in correctional settings.
Disruption in material supply
Silos mentality and unintegrated systems
Logistical challenges for laboratory tests
Insufficient knowledge of care providers
Next Step: Screening & Prevention
With full awareness that we are in the era of the DAA, most hepatitis C patients, if diagnosed, stand a high chance of being cured. But what does that mean for the majority of the suspected undiagnosed HCV cases worldwide ? In a European modeling study published in the BMJ, researchers found scaling-up screening and treatment capacity, and timely and effective retreatment are needed to avail the full benefits of DAAs and to meet HCV elimination targets set by WHO . So, ultimately, the burden will fall on comprehensive screening programs and prevention.
While the 2010s will be marked as the decade we realized how bad the problem was, hopefully the 2020s will be the decade we get a grip on hepatitis C prevention and awareness. And in doing our small part through spreading awareness and information, hopefully we can all make WHOs 2030 elimination date a reality.
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Hepatitis C Drugs Are Pricey
Antiviral drugs for hepatitis C are very effective, but they come at a steep cost. Just one Sovaldi pill costs $1,000. A full 12-week course of treatment with this drug costs $84,000.
The price of other hepatitis C drugs is also high:
- Harvoni costs $94,500 for a 12-week treatment
- Mavyret costs $39,600 for a 12-week treatment
- Zepatier costs $54,600 for a 12-week treatment
- Technivie costs $76,653 for a 12-week treatment
Hepatitis C drugs are expensive due to the large demand for them, and the high cost of bringing them to market. Developing a new drug, testing it in clinical trials, and marketing it can run pharmaceutical companies nearly $900 million.
Another factor adding to the high cost is the lack of a national health care system to negotiate medication costs on behalf of consumers. Theres also little competition from other drug companies. As a result, hepatitis C drug manufacturers can essentially charge whatever they want.
Prices could drop in the future as more pharmaceutical companies get into the hepatitis C drug market. The introduction of generic versions of these drugs should help drive costs down.
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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Comparisons With Existing Literature
To our knowledge, our study is the first to evaluate the real-world costs and cost-effectiveness of DAA treatment in an implemented HCV treatment programme among HIV-infected individuals in a clinical setting in an LMIC. However, our study supports previous analyses indicating that HCV treatment is likely cost-effective in LMIC settings where DAAs are available at low costs. One study in Egypt found that implementing an HCV screening programme with IFN-based DAA therapy compared with no screening would be cost-effective. Compared with IFN-based therapy, IFN-free DAA therapy is superior in efficacy, has shorter treatment duration and better tolerability, yet in many settings historically more costly, though costs continue to fall. Similarly, two cost-effectiveness studies in India showed that implementing HCV screening and treatment with generic DAAs would be cost-saving within about a decade, but these studies did not use programmatic treatment delivery or outcome data. Importantly, none of these studies, ours included, incorporated data on access to healthcare, which may be low in LMICs, and therefore it is possible that treatment is less cost-effective than estimated if fewer medical costs are associated with untreated HCV infection. While our sensitivity analyses indicated that HCV treatment remained cost-effective with no cost of care for hepatic fibrosis stages, further work is warranted to assess real-world medical utilisation for liver disease in LMICs.
What Are The Names Of The Medications For Treating Hepatitis C
Since 2014, multiple different antiviral treatments for hepatitis C have been developed. With the many options now available, often there is more than one good choice for a patient. Some of the treatments are recommended as first-line options, some are second-line options, and others are used less commonly in light of all the available choices.
Second line hepatitis C medications:
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New Advances In Treatment Of Hepatitis C
It is no longer the case now as a major breakthrough in the field of medicine has resulted in the development of two medicines to cure Hepatitis C Sovaldi and Harvoni have been approved by the FDA of India in 2014 and are available now in India. Both these medicines have a very high success rate touching almost 90-100% in some cases. The generic version of Sovaldi medicine is now available in the country and that of Harvoni will follow soon. The generic versions are almost 99% cheaper than the branded ones.
Hepatitis C is a chronic disease of the liver caused by the Hepatitis C virus. It is a disease without boundaries. WHO estimates that around 130 million people are affected by the deadly virus across the globe and around 500 000 people are killed by the disease every year. The virus can gain entry in to the body through transfusion of infected and unscreened blood or use of improperly sterilized surgical instruments and syringes. The disease can be short term or long term. Once inside the body the virus may be expelled out within 6 months in around 15% of the people or remain there for life in rest of the 85% of the patients. The patients generally present with jaundice, yellow urine, bone and muscle pain, belly pain, itchy skin and fatigue. Most people develop liver cirrhosis or cancer eventually which can be fatal.
Q: What Care Should Be Taken By People With Chronic Hepatitis C
A: Standard monitoring of those sufferers of chronic Hepatitis Cby experienced physician is needed. Alcohol has to be rigorously avoided to prevent additional liver damage. Any other drugs, nutritional supplements, and over-the-counter medication shouldnt be taken without consulting the physician. In the event of chronic hepatitis C, then the individual ought to take the vaccinations of Hepatitis A and B.
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