Hepatitis C drugs now covered by Medicaid

[neversickanymore]

Hepatitis C drugs now covered by Medicaid


GRAND HAVEN, MICH. - Good news for some Michigan Hepatitis C patients: as of March, Medicaid will pay for new costly drugs that could cure the disease.

It’s an update to a WZZM 13 Watchdog story last month about the cost of the drugs that in some cases can go as high $100,000. Covered drugs include antivirals, like Sovaldi and Harvoni, for Hepatitis C patients who have severe liver disease.

As we told you in our story last month, the drugs can cost more than $1,000 a pill. Finding a way to pay the medications has been a challenge for state Medicaid programs.

State lawmakers just recently approved funding.

Thousands of Hepatitis C patients who depend on Medicaid have been waiting for almost two years for the approval. One patient we told you about in our Watchdog report, Sherry Baribeau, was getting so ill she could not wait any longer. Family and friends finally purchased a private insurance policy which covered the treatment.

She is now in week four of her 24-week-long treatment.

cont http://www.wzzm13.com/news/investig...tits-c-drugs-now-covered-by-medicaid/64706195

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I hope the people from this raping company get hep C. 4 real.

 

[MyDoorsAreOpen]

I was pretty happy when I heard this news, and it sets a good precedent, but let's not forget this is a battle won, not a war. The system that allows pharmaceutical companies in the US to skin people for needed therapies is still fully in place.

The US is a wild west when it comes to healthcare, and I attribute that to a sort of cognitive dissonance on a national scale: Keep us healthy. But don't intrude upon our rights to fuck up our bodies as much as we want.

In most countries, when a pharmaceutical company approaches their national board of drug-approvers, the board says "The price will be no more than X. Final offer. Otherwise you can take your fancy new drug and walk, because we can do without it." That doesn't happen in the US. If it did, there would be public outrage at the FDA, from a public who feels entitled to the latest and greatest therapies, and to a larger degree than most places, can actually afford them when push comes to shove. I don't mean to imply that nearly all Americans are rich, just that the minority who are, are really really rich. So pharmaceutical companies won't take no for an answer here, and are not above grimy business tactics in dealing with the FDA, because the potential payoff is just too great.

If this trend continues, I might set up a medical travel agency, seeking out banana republics where these fancy new drugs are a fraction of the cost they are in the US, and partnering with clinics and places of lodging there to send patients there for therapy. It's really almost funny when world travel has become cheaper than domestic drugs.

 

[SixBuckets]

The price is a massive barrier to people's uptake of hep C treatment when the drugs aren't funded, but it's only one of a series of barriers to treatment that see people drop out of the system well before they have to think about paying for the medications. Here, I'll show you a picture.

This is the cascade of care for people who inject drugs and have hep C who are accessing Australian community services for hep C treatment. This illustrates the old treatment regime, but most steps are the same with the new DAAs. As you can see, there's a whole heap of steps people have to go through before they can even get their hands on a script for treatment. Even putting aside lifestyle factors that might interrupt the process, people just aren't being adequately supported and empowered to stick with the process the whole way through.

We're expecting uptake and adherence of treatment to increase now that people with most genotypes don't need to take interferon and the course of treatment is shorter and more effective, but the fact remains that at the moment only a tiny minority of people living with hep C are even getting to the point where a doctor can think about writing them a script for treatment. If that doesn't change, hep C rates and complications will continue to rise.

 

[Kittycat5]

SixBuckets, can you show where this graph came from? I only ask because if you look at it without context, it appears that about 1/4 of PWID cant even make it from referral to diagnosis which may strengthen the opinion of those who feel IV drug users cannot be trusted to initiate, comply with and complete treatment.

 

[SixBuckets]

SixBuckets, can you show where this graph came from? I only ask because if you look at it without context, it appears that about 1/4 of PWID cant even make it from referral to diagnosis which may strengthen the opinion of those who feel IV drug users cannot be trusted to initiate, comply with and complete treatment.

It's from this paper http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0142770.

And yes, that is actually accurate, although I don't think you can conclude that this is a feature limited to people who inject drugs. Up to half of people who meet the criteria for type two diabetes are undiagnosed, for example, and one quarter of adult Australian men literally never go to the doctor at all.

It's estimated that around 15% - 20% of people living with hep C in Australia are undiagnosed, but this number includes a large percentage who acquired the infection through past injecting drug use that they stopped doing many years ago. Awareness of hep C is quite low in some demographics - a lot of undiagnosed people living with hep C are older people who may have injected drugs before NSP was introduced in the 90s and don't perceive themselves as being at risk. And I've encountered a lot of people through my work who are current injecting drug users (or prisoners, or engaged in other risky activities like backyard tattooing) who know they have a hep C risk, but don't see testing as relevant or important for their lives. It's not that they can't be trusted to get tested, it's that testing and treatment aren't a top priority to them, because they've just go other things on their plate.

 

[Kittycat5]

Thank you. And let me be clear, I am not thinking the way I said, but those with ignorance or prejudice towards drug users may. But the whole data is pretty clear. If we can just get people to therapy, a high percentage will achieve the goal. And as is pointed out, removing interferon should help some patients overcome their barriers but, and this is my thoughts now, the cost of the direct acting antivirals are probably not doing much at overcoming any barriers on the healthcare (or service as this and other studies call it).

Besides the obvious that many state funded or private insurances wont pay for them and nobody can afford them otherwise, a biased doctor may think why waste these drugs on someone I know wont be compliant moreso even than interferon/ribavarin therapy, which isnt exactly cheap.

Activists can do something about getting the drugs covered. I think calling out state governments (here in America) is the way to do this rather than shaming the pharmaceutical companies (this doesnt hurt, I support it, just dont think they care). But it may take a generation of healthcare professionals until enough of them listen to the facts and ignore things like drug use, alcohol consumption and mental disease as being prohibitive factors in giving everyone a shot at these drugs. Hope not but can only wait and see.

 

[manboychef]

I have been trying to get my hep c cured for over two years now. I have had it since age 15 and am now 33. I am fairly sick. The insurance companies have had me get blood test after blood test, fibrosur tests, biopsies, and many sitdowns with my gastroenterology doctor. I have tried different insurance companies and both keep denying me. I also happen to live in florida which did not expand medicare (which would have made access to these treatments easier). I no longer use IV drugs and have been sober for a year and five months (which one of the tests they require is many urine screens) and they still just keep giving me the runaround. I can no longer work due to the intense fatigue and malaise I feel. Also, my ankles, elbows and hands swell up in an incredibly painful manner at least once a month. I am at the point of being angry. I have to pay co-pays every time I get blood panels done, and I have to pay $400 dollars a biopsy and I have had three so far.

I guess I am just angry. I seriously hate when a drug like this is way less expensive in australia or engand, and then in the states it is way far out of reach for people like myself.

 

[SixBuckets]

Thank you. And let me be clear, I am not thinking the way I said, but those with ignorance or prejudice towards drug users may. But the whole data is pretty clear. If we can just get people to therapy, a high percentage will achieve the goal. And as is pointed out, removing interferon should help some patients overcome their barriers but, and this is my thoughts now, the cost of the direct acting antivirals are probably not doing much at overcoming any barriers on the healthcare (or service as this and other studies call it).

Besides the obvious that many state funded or private insurances wont pay for them and nobody can afford them otherwise, a biased doctor may think why waste these drugs on someone I know wont be compliant moreso even than interferon/ribavarin therapy, which isnt exactly cheap.

Activists can do something about getting the drugs covered. I think calling out state governments (here in America) is the way to do this rather than shaming the pharmaceutical companies (this doesnt hurt, I support it, just dont think they care). But it may take a generation of healthcare professionals until enough of them listen to the facts and ignore things like drug use, alcohol consumption and mental disease as being prohibitive factors in giving everyone a shot at these drugs. Hope not but can only wait and see.

I'm doing a project on this right now (the new treatments have just been subsidised by the government in Australia so are now affordable here) and am interested to see whether the perceived barriers to treatment have decreased. There's also some rumblings about the move to measure fibrosis via blood test, too, which means that people can get their fibrosis level measured when they get their genotyping PCR, rather than having to get a fibroscan or liver ultrasound (which is non-invasive, but still an extra step in the process). The easier and more accessible we can make the process of diagnosis and treatment, the more people will stay in the system.

I have been trying to get my hep c cured for over two years now. I have had it since age 15 and am now 33. I am fairly sick. The insurance companies have had me get blood test after blood test, fibrosur tests, biopsies, and many sitdowns with my gastroenterology doctor. I have tried different insurance companies and both keep denying me. I also happen to live in florida which did not expand medicare (which would have made access to these treatments easier). I no longer use IV drugs and have been sober for a year and five months (which one of the tests they require is many urine screens) and they still just keep giving me the runaround. I can no longer work due to the intense fatigue and malaise I feel. Also, my ankles, elbows and hands swell up in an incredibly painful manner at least once a month. I am at the point of being angry. I have to pay co-pays every time I get blood panels done, and I have to pay $400 dollars a biopsy and I have had three so far.

I guess I am just angry. I seriously hate when a drug like this is way less expensive in australia or engand, and then in the states it is way far out of reach for people like myself.

I'm really sorry to hear that - it sounds like a really shitty situation.

Are there buyer's club programs where you are that would assist you to import generics of the medication privately? We had one running in Australia, but it's shut down now that the drugs have been listed on our subsidised medication scheme.

 

[manboychef]

I have searched every avenue in the last two years. I have tried interfuron as well and my hep came back harder than before.

Insurance companies are the true death panels.

What needs to be done is medications that save lives should be subsidized regardless of how expensive they are. Make rich old men's boner pills more expensive, make elective surgeries like breast augmentation more expensive, and for the love of god take away politicians healthcare for life. If we stopped paying for politicians that are not in office anymore to have the best healthcare we could make HIV, Hep C, and cancer drugs way less expensive.

@mydoorsareopen: If you end up doing that, look me up. This illness is killing me. If I garden for a couple hours I am exhausted and sick for the next couple days. I have extremely rusty urine. When I have a flareup my joints hurt so bad that I can barely walk and my shoes don't fit. I am losing weight incredibly quickly because I am nauseated quite a bit. I can't work anymore which has made me incredibly depressed, yet I cannot get disability. I know it is my fault that I have this virus, but does youthful indiscretion truly make me unworthy of good health?

 

[SixBuckets]

I have searched every avenue in the last two years. I have tried interfuron as well and my hep came back harder than before.

Boooo

What needs to be done is medications that save lives should be subsidized regardless of how expensive they are. Make rich old men's boner pills more expensive, make elective surgeries like breast augmentation more expensive, and for the love of god take away politicians healthcare for life. If we stopped paying for politicians that are not in office anymore to have the best healthcare we could make HIV, Hep C, and cancer drugs way less expensive.

This is kind of the system we have in Australia. Drugs still need to be approved, but most medications with a measurable benefit are subsidised by the government and cost around $40 to the consumer (or $6 if you have a concession card). We don't subsidise cosmetic surgery on either our public or private health system, and (in my state at least) HIV medication is actually completely free.

It's not perfect, and quite a few less common medications (like drugs for rare cancers) aren't subsidised. Things also get subsidised for one specific thing, leaving the consumer to pay the full cost if their doctor prescribes it for anything else. But still, the horror stories I hear about the US system make me very thankful I live in Australia.

I know it is my fault that I have this virus, but does youthful indiscretion truly make me unworthy of good health?

It's not "your fault" that you have a blood-borne virus. That's not how health works - it's not a moral issue. Some people who made the same choices you did had no repercussions, and other people contracted hep C from completely "innocent" actions like workplace needlestick injuries or blood transfusions. You are no more or no less worthy of good health than anyone else.

I know it's hard, but try not to blame yourself. It sounds like you're already feeling pretty shitty and you don't need to talk yourself down on top of that.