- High cost of Hep C drug a barrier to treatment
- Are High Cost Hepatitis C Medications Worth the Price Tag?
- The cost of the curing Hepatitis C – BBC Newsnight
- Measuring Costs For Hepatitis C Treatment
- Conversation about drug pricing | Health care system | Heatlh & Medicine | Khan Academy
- Hepatitis C cure is not covered by some insurance plans
- With highest hepatitis C mortality rate in U.S., Oregon expands access to life-saving drugs
High cost of Hep C drug a barrier to treatment
today a Senate report found that Gilead,Sciences which makes a cure for a fatal,form of hepatitis is more interested in,profits than patients the cure was,invented under the leadership of a,celebrated doctor in the Department of,Veterans Affairs but at $1,000 a pill,even the VA cant afford to save the,lives of vets who need it,chip Reid has been looking into this in,2013 Vietnam veterans ioan Israel was,told he had five years to live he has,stage 4 liver disease caused by,hepatitis C which has infected as many,as two hundred thirty thousand veterans,most contracted it in Vietnam where it,was spread by battlefield blood,transfusions and vaccinations the longer,it goes the harder it is to treat after,decades of suffering earlier this year,Israel was overjoyed to learn theres a,cure I felt like my prayers were,answered I am ready to be cured the drug,sophist Bevier is sold as sovaldi and,harvoni and claims to cure up to 99% of,hepatitis C patients but theres a catch,the retail price for a twelve-week,treatment is eighty four thousand,dollars the Department of Veterans,Affairs gets a 50% discount but even,with that the VA told Israel they cant,afford to give it to everyone who needs,it including him come back next year,and then all the time Im thinking about,that well my condition is getting worse,dr. Raymond Shaughnessy founded the,company pharmacy and led the scientific,team that discovered so fast Bevere he,also works for the Department of,Veterans Affairs and has since 1983 he,says hes only a 7/8 government employee,and what he does with his remaining time,is up to him so youre only spending 1/8,of your time on your private companies,well even less than that,even less yes Im very efficient,dr. Shahnaz he made more than 400,million dollars when he sold his company,for 11 billion dollars to pharmaceutical,giant Gilead in 2012 can you see how,that looks to an average veteran youre,taking it personally if youre surprised,that a government scientist can make,that kind of money given federal laws,surrounding conflicts of interest so,were we has anybody ever questioned the,arrangement you have that allows you to,become very wealthy while working 7/8 of,your time with the government,nobodys ever questioned yet I think,Ive done everything Ive disclosed,everything to the VA the VA declined our,request for an interview but approved,the arrangement and in a statement said,federal employees are allowed to invest,in private companies provided all,conflict of interest rules are followed,gilead the company that now owns and,sets the price on sovaldi and harvoni,told us the cost is in line with the,previous standards of care but in this,2013 trade journal dr. Shahnaz II said,it only costs about fourteen hundred,dollars to manufacture the full 12 week,treatment thats less than two percent,of the retail price why is it so much,more expensive than what it cost to make,it thats a good question I mean I think,the price will come down eventually,Zion Israel wonders if the price will,come down in time to save him in the two,years his doctor says he has left its,just not right that the vets would risk,their life and come here and because of,$84,000 you know if you cant get cured,of medication produced by the country,that were protecting dr. Shahnaz ii,says the drug he helped create has saved,hundreds of thousands of lives around,the world but Scott the VA concedes that,funding for US veterans is limited so,far theyve treated about 35,000 thats,just 15 percent of the veterans infected,with hepatitis C chip Reed with a,revealing story in our Washington,newsroom chip thanks
Are High Cost Hepatitis C Medications Worth the Price Tag?
in late 2013 to drugs were approved by,the FDA to treat chronic hepatitis C,virus one of these agents with saval d,the third drug receiving breakthrough,therapy designation from the fda the,breakthrough therapy was the first drug,approved to treat chronic hepatitis C,without the co-administration of,interferon a drug with numerous side,effects that often led to non adherence,with treatment regimens unfortunately,along with this new treatment regimen,comes a hefty price tag thousand dollars,per day or eighty four thousand dollars,for an average duration of treatment,thats not including the cost of,co-administration of ribavirin and,possible interferon savall DS launch was,thought to be the biggest in history and,has already been used to treat,approximately a hundred and seventeen,thousand patients suffering from chronic,hepatitis C Saval D has demonstrated,higher than ninety percent cure rates,associated with its use but is this,worth the costly price tag with that,ninety percent curate curate stacy is,that price tag worth it well I think to,say that this of all the example is a,very unique case study is certainly an,understatement theres really no doubt,that its very expensive but its sort,of interesting to think about it if it,wasnt a drug that cured the virus in 12,weeks but instead was used over 15 years,to suppress the virus and potentially,reduce and end-organ damage at a cost of,fifty six hundred dollars a year over 15,years we would think of it much,differently however thats not the,reality the reality is eighty-four,thousand dollars in 12 weeks hitting,budgets in a particular budget year and,I think thats really one of the ways,thats made this discussion so unique i,think the other real issue that we see,with the hepatitis C treatment,population is the sheer numbers the CDC,really estimates that approximately 3.2,million Americans have hepatitis C so,certainly in the specialty space were,used to dealing with very high cost,drugs we see high cost drugs all the,time but we typically see them in,orphan disease states more theres very,few patients across the country being,treated and the issue with this is that,we really have a tsunami of patients to,be treated that are hitting payers all,at once with this incredibly high cost,so I think those are a couple of things,that really make this of aldi and the,hepatitis C example very unique within,this past year I was thinking that it is,worth the price tag for some patients,but maybe not all patients so its,important to understand the hepatitis C,is a very slow progressing disease and,then all patients are going to end up,with cirrhosis or liver transplant so,the CDC estimates for every 100 patients,that infected with chronic hepatitis C,but 60 to 70 of those will go on to have,liver to liver damage but only five to,20 will actually develop cirrhosis and,and may and which may lead to liver,transplantation or liver cancer so when,you think about that you know should all,of the patients that have hepatitis,Sierra infected be treated with these,drugs we know it is a cure for every,patient but if not every patient is,going to go on to develop cirrhosis and,have these you know severe effects of,the disease it really makes you question,it and I know recently I read that a,large portion of the patients I believe,there were fifty percent or more did not,have advanced disease that were treated,with civ all d of those hundred and,seventeen thousand patients so I think,you know as new therapies entered the,market place i think you know payers,need to be thinking about you know which,patients are the most important to treat,do we need to treat all of them and is,that the way would that we can afford,the treatment for those that you know,really do need it very good any other,comments you know becomes a very,challenging dilemma and really specialty,pharmacies is somewhere in the middle we,do a large portion of hepatitis C and,you know one particular Medicaid area,the state Medicaid program we had,they had not approved the drug in the,beginning of the year and they were,trying to make it go through formulary,and you know figure out how theyre,going to handle it well it turned out,that we had ninety percent of those,referrals where were sending from my,organizer or our organization so we went,down and we met with the state Medicaid,program and when you hear the program,tell you that if they approved every,authorization thats out there they,would spend the whole years budget and,and how do you balance that how can a,program pay for the hepatitis C patients,and that everyone else who needs a medic,a prescription the fundings not there,and then the other interesting we met,with another large player in the midst,mehdi space and they looked at their,claim data and said what we only did for,we only paid for fortran liver,transplants last year how much is all d,really helping our organization in our,patient population so i think,appropriate use is something important,with these with these higher cost agents,thats an eye opening statement that you,got from the state that was a meta,believe its kinda thats thats the,dilemma in the challenge it can even,commercial health plans are facing we,all know that patient affordability is,as a barrier to start a therapy and in,fact if the co-pays are high enough it,could be actually a denial for that,patient to get treatment is that an,issue with the with the Hep C drugs are,we seeing high co-pays and patients are,you know essentially not being able to,get therapy because of affordability,issues any thoughts at our organization,were for the commercial patients were,not seeing that the manufacturers are,supporting copay offsets and those are,being effectively applied so were not,seeing that but in the non-commercial,you know those government payers we are,seeing patients who do have financial,barriers in that regard were leveraging,the funding organizations penn ave path,cdf to help,appropriate utilization its great,especially pharmacy does that yeah,absolutely i think you know if you look,at in our organization the the cost,barrier is really almost nil in this,space theres plenty of funding we work,directly right with the liver,foundations and and there theres the,opportunity to once the patient is,approved you know the co-pays not,usually a limiting factor and of course,with the Medicaid population if they do,get approved you know again the copay is,not an issue harvoni was approved by the,fda in october for the treatment of,hepatitis c patients with genotype 1 the,combination drug is manufactured by the,same organization as savall d harvoni is,a combination ns5a inhibitor and a,nucleotide analogue ns5b polymerase,inhibitor this once daily drug is,demonstrated efficacy with consistent,SVR rates above ninety percent in,addition to this newest agent several,other hepatitis C drugs are expected to,appear in the marketplace soon Renee do,you believe this competition will lead,to decrease costs within hepatitis C yes,and no so harvoni came to the market the,first oral agent it combines two,antivirals as we mentioned its a once a,day treatment and it was FDA approved,for shorter treatment duration so some,patients can actually qualify to use it,for eight weeks which offers a little,lower price and then other patients,standard pretty much as 12 weeks and,then the worst patients 24 weeks there,are other competitors ready to come to,the market one of the competitors a BMS,product pulled their application because,they couldnt achieve SVR rates close to,where her body was the next competitor,ave products its questionable as to,whether or not it will come to the,market approved without the use of our,brevard and that particular product,contains three antivirals if it is,approved with the use of ribavirin,patients will have to take multiple,tablets and some of them twice a day,which we may make adherence an issue,so in order to have competition in terms,of decreasing the price to harvoni these,pr
More: conjoint analysis for pricing
The cost of the curing Hepatitis C – BBC Newsnight
Im waiting for the results might for my,end of treatment results so shes going,to fax them straight through him and,then hopefully you get back to me,Sean reading desperate and unable to get,hepatitis C treatment within the,healthcare system has taken matters into,his own hands,millions worldwide face this dilemma,Ive been making film about access to,treatment for the hepatitis C epidemic,for over a year I found out I had Hep C,in 1998 its highly contagious and can,cause cirrhosis and liver cancer,previously treatment was very toxic now,there are new drugs which cure with,virtually no side effects I live in,Germany where I was prescribed treatment,with the new drug havona,I am now cured Ive come back to the UK,to find out why people here arent,receiving the same treatment as me Im,starting with dr. Andrew hill an expert,in drug pricing if you look at the cost,of these treatments theyre,fundamentally cheap drugs they cost,hundred pounds per course to make that,12 weeks of treatment for one person,that same treatment is being sold in the,United Kingdom for 35,000 pounds so its,just such a huge price that the National,Health Service and nice have been,hesitating theyve been waiting to,decide who should be treated first yet,be on our investigation dr. hill told me,about the US Senates investigation into,pricing which is focused on one,particular pharma company Gilead using,Gilead,own documents the evidence shows that,the company pursued a calculated scheme,for pricing and marketing its hepatitis,C drug based on one goal maximizing,revenue regardless of,the human consequences how many billions,do they need to make before they start,lowering the prices these drugs are,fundamentally cheap but theyre not,being accessed by most people because,the prices are so high one of the,reasons theres so little protest about,the high price of hepatitis C treatment,is that patients are often stigmatized I,went back to see my old doctor to ask,him about this stigma being silent about,hepatitis C is doing no-one any favours,I think there is an incredible amount of,stigma and I think that stigma probably,comes from the days of hepatitis C being,labeled as a disease of intravenous drug,use and of intravenous drug users not,being a useful part of society I went to,see doctor Magdalena Harris who is,researching the experiences of people,with hepatitis C for them a trip to the,dentist is always complicated the issue,of the last appointment Ive been,hearing that for the last ten years in,conducting research for people living a,few potaters see that Im given the last,appointment of the day by my dentist,which is absolutely unnecessary we need,two distinct eyes this and say this is,this is an infection its no different,from any other infection its an,infection that people catch and that,needs to be treated one person who,hasnt been able to access NHS treatment,is Jew Janice nary recently diagnosed,her appointments keep getting postponed,she isnt sure how she was infected with,hepatitis C whats she planning to do,about treatment I dont know I dont,know what what I should do really I am I,suppose I mean Ive been trying to sign,up with trials without any success I,know you can also get her drugs from,India cheaper and I dont know,Julianas life and health are being,badly affected because she isnt getting,treatment ten years ago when I had,breast cancer and stopped the HRT I was,quite fit and well and during the last,ten years I have gradually got worse my,stamina has gone my mobility has been,drastically reduced whereas before I,could walk for hours without getting,tired now I dont Im not able to walk,at all I use a mobility buggy outside,some people are taking treatment into,their own hands and to finding answers,online buying drugs off the internet is,is a new thing its an emerging way of,being treated and one issue is do you,know that the medicine that youre,buying is genuine all these places will,give information for anybody and how to,Shaun reading couldnt get treatment in,Ireland the Irish Health Service like,the NHS cant afford to treat everyone,online he found the Australian based fix,Hep C buyers club through them he bought,clinically tested generic drugs buyers,club I became a member of the buyers,club and had my appointment via Skype,with doctor Freeman,I sent him all my documentation from my,blood test results from Ireland and he,said yes its possible he can if I come,over to Australia I can come to him he,can give them to me,Shaun paid about seven hundred and fifty,pounds for treatment that will cost the,NHS around thirty five thousand pounds I,have now completed twelve weeks of,treatment,last Monday sorry last Sunday night I,went from my blood test on Monday,I am now waiting for my end of treatment,results as we speak,my GP dr. Johnny Fleetwood and Dublin is,on the phone mm-hmm he has the results,of my end of treatment tests and so good,afternoon dr. Fleetwood Im very well,thanks a little bit upper hands of a,nervous but excited at the same time,excellent,Johnny GaN is brilliant news anything,are you go yeah you know Ive lived with,hepatitis since 1980,thats 36 years in the UK it is legal to,get three months treatment delivered to,your door so for those patients who can,pay for it,the online buyers club may be an option,but most will have to wait and see,whether the NHS can afford to treat them,this is billions of pounds in funding at,a time that the NHS is in very difficult,financial situation so it just doesnt,seem feasible that were going to be,able to eliminate hepatitis C within the,next 15 or even 20 years with prices,this high but we could we clearly,definitely could if we could get these,drugs at lower prices that report from,Kate bramble degree asked to speak to,Gilead who you had mentioned there about,the cost of their drugs but instead they,sent us a statement while we appreciate,senator Wydens attention to this issue,we respectfully disagree with his,conclusions both solve our D and harvoni,are deemed cost-effective by the,National Institute for Health and Care,excellence the one-time cost of Salvati,sovaldi or have harvoni pales in,comparison to the lifetime cost,associated with untreated HCV well with,me now virginia executive director of,the association of the British,pharmaceutical industry good evening to,you Devon we know that the drug,companies have to be recompense for the,research the billions they spend on,research do you think theres any limit,to the price they should be allowed to,charge,I think were focusing a lot on price,and what I didnt hear at all,not really you know impactful video was,the value that were getting through the,way these medicines are being introduced,in healthcare and when nice gives an,approval thats not just a tick because,we think its great that its a curative,treatment thats because theyve looked,at does it make sense to spend the,British payers pound on this medicine as,opposed to any other intervention we,could do really carefully so it really,does make sense doesnt it no ones,going to dispute its a great these are,great drugs is really really great drugs,but look lets suppose it has a hundred,thousand pounds of benefit do you think,its reasonable for the drug company to,charge,ninety nine thousand nine hundred and,ninety nine pounds and say look youve,still got a pound of benefit and thats,thats the benefit of an open system,that we have like in the UK where we can,negotiate and lets be honest I mean the,list price that weve been hearing about,is it necessarily whats getting paid by,the healthcare services there is some,very competitive and effective discount,going on wait wait wait wait so we you,think we might be paying less than,thirty five I would almost a guarantee,that with that within the process of the,way we negotiate access Arrangements,under dies and directly with the NHS,that the government does a very good job,of making sure that its being a careful,buyer when theyre investing in new,medicines and lets re
More: pricing b2b
Measuring Costs For Hepatitis C Treatment
so goal is to look at how the disease,will change especially the cost of,treatment we know that there have been,several issues with the cost payers are,not able to provide treatment timely,treatment of patients with the rising,cost of the drugs so we wanted to know,how much would it cost to the society in,general to treat everybody whos been,diagnosed with hepatitis C and how much,would it cost to make hybrid señor ear,disease in the country we published just,early last year showing that Pepsi can,become a rare disease by 2040 around,20-40 and then in this study we looked,at the cost of making reaching that,projection,we start,jacking the disease burn year by year in,2010 before the launch of ba is the the,cost of hybrid icing here was around,seven billion dollars per per year with,the launch of das in addition to the,expansion in the insurance coverage,because of Affordable Care Act plus,because of the impact of screening,updates the cost of heaven se kare,jumped to 22 billion this year in 2015,from seven billion in twenty ten to,twenty two billion this year and 17,billion were spending on treatment this,year,number of factors medications are more,expensive number of people were training,or is very large number of people who,are aware of the disease is large people,who have insurance now has increased so,multiple factors,for patient care I think if theyre,getting care doesnt mean much its a,good thing for them its all wonderful,because they can get cured of the,disease to the health care system it,means a lot because we still are not,able to treat everybody who has been,diagnosed with hepatitis C so we have to,further increase our treatment capacity,how do we do that by removing,restrictions for example Medicaid has,restrictions on who can get treatment if,patients are their history of active,injection drug users they are not,reimbursing for drugs so removing these,restrictions will definitely help,earlier in the year we saw that several,the other pairs were also restricting,treatment based upon the fibrosis a,degree of the disease severity people,who are more advanced you can get,treatment wearers less severe should not,right now they should wait so we have to,remove those restrictions,there are a lot of issues with that,because I think our system is not,prepared for this Medicaid for example,did not have budget they do not have,allocated budget to treat everybody they,would anticipate getting drugs next year,so they decide them Buzzard one year in,advance similarly V is where the,prevalence is also very high veteran,affairs they did not plan for this very,well so because of these factors there,is a restriction on the budget how much,they can allocate to have rat asleep,that means they have to remove budget,from some other areas and put then,hepatitis C so thats probably one of,the limitations of the system,what would be the reason if the reason,is that they dont have insurance then,what Ive heard is several,pharmaceutical companies are providing,system programs they can approach them,to get treatment if the patient is,Medicaid on Medicaid and Medicare is not,reimbursing so thats very unfortunate,situation I dont know what to say to,the patient but since I patient would,have to wait and maybe a year or so at,least when the more budgets available,these patients are treated,can cost may not,some discount be pairs are giving,getting discounts because of the,competition now so practically there has,been some impact though the listing,price remains the same and that eighty,to ninety thousand dollars but,practically what we are paying is much,lower than what we saw last year when,the drugs were approved but what whats,interesting finding of our analysis is,that the bottom is declining very,sharply in the next few years for,example by 2020 the budget the total,spending on hepatitis C would be below 5,billion dollars because we would have,treated most of the pigeon big number of,patients who need these therapies then,by 2030 thats when we anticipate,generics would become available in the,u.s. we would have traded most of the,patients and they would not have any,impact on the cost of here,another,objective of our study was to look at,how much would it cost to make this,disease rare and it found that its,totally 101 or six billion dollars which,is substantial amount of money but if,you compare that with HIV spending in,the last five years only we spent 140,four billion dollars on hiv/aids so and,this with several 37 public that show,that number of people dying from hybrid,AC in the last few years is more than,that from HIV,so one of the limitations of this work,was we did not include the,institutionalized population the people,who were in presence homeless population,the business burden is very high in this,in these two populations so how do we,bring these people into the system and,then who pays for their treatment so,thats a big crash,before,for da is we found that number of I,rimac people people who are hiv-positive,and still need treatment was around 2.4,billion dollar sorry 2.4 million and,then in this year 2015 we projected that,around two million people need treatment,and moving forward by 2020 less than 1,million people would need treatment and,then we also looked at how many people,are aware of the disease in this year,and then how would that would change in,your future we found that around 900,000,people in this year still dont know,they have hepatitis C and human in the,next five years in spite of the,screening updates since training,policies for hepatitis C by 2020 we,still anticipate half a million people,would remain unaware of the disease,the message here we project is that,theres no doubt das would do very good,in reducing that is this burden but the,burden still remains very high even in,the air of DA is because we now,essentially have a cure of a disease and,still we see that many people would,advance these adverse outcomes like,liver cancer Doug and I could die from,hepatitis E,so we need definitely need better,screening and then how do we provide,treatment those people who would be,diagnosed with a bracing another,population thats growing is number of,people who achieve sustained virologic,response which is the surrogate of cure,for hepatitis C however many of these,patients would still be at high risk of,developing hobart a cell carcinoma so we,need active surveillance and these,people otherwise they could many of them,could advance to hcc or diaphragm liver,disease,hidayat its for everybody because there,if now we calling them peach patients,are cured they were not calling a,patients anymore there so they may not,be going to have a dollar is regularly,so they made me go into general,practitioner so they need to be aware of,this population because they still am I,risk,well we hope that we would have treated,majority of patients who were aware of,the disease even lie we would have,diagnosed more and more patients in the,near future and we hope that it will not,be a serious disease anymore
Conversation about drug pricing | Health care system | Heatlh & Medicine | Khan Academy
أنا هنا مع البروفيسور لورانس بيكر من كلية الطب جامعة ستانفورد وأنا على أمل أنه سيتمكن على الأقل,من أن يبدأ يجعلني أفهم شئ كان دائما يثير تساؤلاتي و يقلقني قليلاً، دعنا نقول,أنا من شركات الأدوية – شركة فارما A – دعونا نقول أني استثمرت 10 سنوات و100 مليون دولار في بعض الأدوية,لقد حصلت عليه من خلال جميع التجارب الطبية وحصلت على الموافقة عليه من قبل ادارة الاغذية والعقاقير ويقال من أجل,ببساطة انه يداوي من المرض x، الآن فور وصولي الى هذه النقطة. اشعر كشركة فارما برضا عن نفسي .,ماذا يحدث بعد ذلك؟ أنا افترض انه ربما علي ّ الذهاب لتكلفة التأمين، الرعاية الطبية والصحية وأحسب كم,سيدفعون لها. كيف ستحدث هذه المحادثة.,الدكتور: نعم أنت ذاهب لإجراء محادثة مع مجموعة مختلفة من الناس، في الولايات المتحدة لدينا الكثير,من خطط تأمين خاصة مختلفة، لدينا خطط حكومية ونحن في الواقع سنجري محادثات,مع اوروبا و مع بعض الأنظمة الأخرى في جميع أنحاء العالم، وذلك لأن كل نظام له طريقة مختلفة أو متشابهة لفعل ذلك يريدون التحدث معك حولها,سال: هل هناك ميل أن تكون نظام قيادي ؟ هل هناك ميل أن تكون أوروبية أو هل هناك ميول أن تكون,شركات تأمين خاصة في الولايات المتحدة أو هل تبدأ جميع تلك المحادثات في آن واحد، كما أن هناك الكثير من المال على الطاولة؟,الدكتور: ستكون هناك استراتيجية أو ستأتيكم أعمال كما سيكون من الصعب تلقي,جميع المحادثات تماما و في وقت واحد. سوف نتحدث الى الولايات المتحدة وسوف تتحدث إلى أوروبا,هناك بعض الحالات التي قد ينظر الناس فيها الى العمليات التنظيمية في أوروبا أسهل قليلا في بعض الأشياء ، حتى أنها قد ترغب البدء في أوروبا,ولكن في حالات أخرى أنت تبحث عن أدوية التي في بعض النظم الوطنية في أوروبا اقل عرضة,لتدفع ربما عليك أن تبدأ مع الولايات المتحدة حيث هناك مرونة أكثر من ذلك بقليل.,سال: ولكن القاعدة العامة للقبول تقضي بجعل المال بالدرجة الأولى في أوروبا والولايات المتحدة في الوقت الراهن؟,الدكتور: وهناك الكثير منه وهناك أنظمة آسيوية أخرى، بعضها متطور جدا,ويستخدم الكثير من الأدوية المتقدمة جدا ولكن أعتقد أن الأغلبية منهم في الولايات المتحدة.,سال: صحيح، وبين أوروبا والولايات المتحدة، أعتقد، تخيلت دائما أن أمريكا الشمالية كانت مكان الجزء الأكبر من المال ، ولكن هل هذه هي القضية؟,الدكتور: الولايات المتحدة، أنا آسف أن نظم الرعاية الصحية لدينا تنفق أكثر من أي بلد آخر في العالم، وهذا ينطبق على الأدوية أيضاً,نحن ننفق على الأدوية هنا أكثر من أي مكان آخر,SAL: نعم، وبالتالي إذا أنا شركة فارما A، أريد أن أتأكد من أني حصلت عليها بشكل صحيح في الولايات المتحدة.,الدكتور: نعم، في نهاية المطاف ربما يهتمون كثيرا.,سال: ويستند جزء من الاستثمار الخاص بي الذي كنت قد طرحته على بعض التفاهمات أنه إذا حصلت على جميع الطرق التي,أود أن أحصل من خاللها على نموذج من العوائد داخل الولايات المتحدة، لذا، هل بالضرورة، احصل على االرعاية الطبية فوراً في حين انها واحدة,من أكبر اللاعبين أو سوف أذهب كمثل من تحدث عن الصليب الأزرق، بلو شيلد,أو كايسر أو بعض اللاعبين الآخرين؟,الدكتور: الرعاية الطبية هي نوع مثير للإهتمام لأسعار الأدوية بسبب أن الرعاية الطبية تاريخياً,لم تكن و لاتزال ليست غطاء كبير في كثير من الأدوية التي تسمع عنها – وبالتالي ،لاتسدد الرعاية الطبية بنفسها على أدوية مرضى العيادات الخارجية، يمكنك أخذها في المنزل.,سال: حقا، أنا افترض دائما – لم يفعلوا ذلك؟,الدكتور: لم يفعلوا ذلك، الرعاية الطبية في الجزء الرئيسي – سوف تغطي الجزء A ،B، الجزءc – لذلك اسمحوا لنا الذهاب والبدء هناك، الجزء A و B,هم توجهو الى عدم التغطية إلا أنها سوف تغطي الأدوية للمرضى الخارجيين إذا حصلت على الدواء في المستشفى في اثناء وجودك في المستشفى، ستدفع الرعاية الصحية لهؤلاء وبذلك سوف تحصل على دواء,يستخدم في المقام الأول في هذا الوضع – ستذهب لتتحدث للرعاية الصحية عن ذلك، والذي سيكون جزء مهم,من المحادثة – ولكن إذا كنت تتحدث عن دواء للمرضى الخارجيين سوف تتحدث للكثيرين.,سال: أنت تقول المرضى الخارجيين، المرضى المنومين هو عندما تكون في المستشفى، كنت مريضا، و تقول أحتاج المورفين الآن، وهذا الدواء للمرضى الداخليين المنومين. العيادات الخارجية هو أن تعود إلى المنزل، وتأخذ هذا 3 مرات يوميا,الدكتور: نعم يرسلك شخص إلى الصيدلية لصرف وصفة طبية، ستأخذها معك للمنزل- التي من شأنها أن تكون أدوية في العيادات الخارجية. لذلك، لا تغطي الرعاية الطبية القسم الرئيسي من الجزء A و B ، هناك قسم الرعاية الطبية الجزء دال الذي هو خطة الأدوية في الرعاية الطبية وهي التي سوف تغطي,الكثير من الأدوية للمرضى الخارجيين. سيكون لديك محادثات معهم، ولكن معظم خطط قسم الرعاية الطبية,هي أساسا شركات خاصة التي تعاقدت معها الرعاية الطبية لذلك أنت حقا لا تتحدث إلى الحكومة,في تلك المرحلة، كنت تتحدث إلى الخطط الخاصة التي تعاقدت مع الرعاية الطبية.,سال: أرى، لذلك مرة أخرى العودة إلى جوهر المسألة، وكيف لهذه الأدوية أن تدفع,لهم ؟ كيف سنحدد السعر الذي سيغطي هذه الأدوية، إنه يعود إلى الخطط الخاصة,مرة أخرى؟ لأنها تسير على العقد، الجزء D وهو الذهاب الى القول اننا في سبيلنا للذهاب إلى أي خطة أخرى أو أي من كان,الدكتور: كل من تقدم بتلك الخطط. سال: كل من فاوض خطة الجزء D- لذلك هي ستستحوذ على ما فاوض عليه الطرف الخاص مع شركة فارم. الدكتور: أو يمكن أن يتعلق به.,سال: دعونا نقول اني دهبت إلى، لدينا نوع من التأمين – دعونا نسمي هذا شركة تأمينY و أنا اجري,محادثات مع شركة التأمين y – انا ذاهب الآن هناك صفقة كبيرة مع المرض X فقد قتل الناس. أريد مليون,دولار بكل فاتورة، الدكتور: دكتور: نعم، تلك كانت محادثات مثيرة للاهتمام حقاً في الولايات المتحدة حتى لا يكون هناك مساومة صعوداً وهبوطاً بين شركات التأمين وشركات تصنيع الأدوية.,وقد أنفق صانعي الدواءالكثير من المال – كنت قد حصلت على مائة مليون هناك.
Hepatitis C cure is not covered by some insurance plans
living weather disease thats destroying,your liver and put elderly kill you you,hear that theres a simple non-toxic,treatment that could cure you but you,cant get it thats the reality for,millions of Americans living with,hepatitis C local 10 medical specialist,Kristi Kruger takes a closer look at the,battle being waged between doctors,patients and insurance companies in the,fight for the Cure this tiny pill could,be a life changer for someone diagnosed,with hepatitis C literally curing them,of a condition that can ultimately lead,to liver failure and liver cancer very,simple to use one pill a day for 12,weeks its almost a hundred percent cure,rate but getting that pill is not so,easy its like oh theres hope but not,hope for me is it well theres four dirk,Stokes was diagnosed with hepatitis C,eight years ago during a routine,physical for an insurance policy his,option then a torturous 12-month,treatment that had a very low success,rate he was thrilled when Mount Sinai,infectious disease specialist Claudio,tudi told him about a cure then his,insurance company turned him down,theyve told me I wasnt sick enough the,pill sold under the brand name Salvati,costs approximately one thousand dollars,a day,standard course of treatment is 90 days,thats a total average cost of 90,thousand dollars for a cure I have some,patients that were fortunate and after,their insurance pray for it and they are,cured,Jeff also cello was one of the lucky,ones but it was still a battle every,single month I had to go for a blood,test and they had to make sure that I,was still undetectable and that the,medicine was working otherwise they,would not pay for it so every month it,was a race to do this to make sure that,I didnt run out of medication and a,couple of months it actually got here,the day that I was due my dose,and I was so freaked out that I would,miss a few doses and it would ruin the,chance of me being cured now infectious,disease specialists as well as activists,say they are gonna keep on fighting to,get this drug into the hands of those,who need it most,we keep knocking at the door until you,know they get tired of us thats thats,what the game is right now you know keep,applying applying until the nation gets,gets approved now an estimated 3.2,million Americans are living right now,with hepatitis C and dont even know,they are infected worldwide 170 million,people are afflicted with this virus the,World Health Organization is now leading,the charge to make this drug more,affordable and available to those who,need it but those efforts may not come,soon enough for so many people with a,special health report im kristy krueger,local 10 News Thank You Kristy and,remember this is a deadly disease an,estimated 15,000 Americans will die this,year from complications due to hepatitis
With highest hepatitis C mortality rate in U.S., Oregon expands access to life-saving drugs
JUDY WOODRUFF: Now: the latest on a medical breakthrough thats starting to have an impact,on a hidden, deadly epidemic in this country.,New drugs can cure up to 95 percent of patients with hepatitis C, a virus that often leads,to debilitating or deadly results.,The drugs can save lives, prevent expensive hospitalizations and liver transplants.,But some states are feeling the squeeze of the cost of this medicine.,Special correspondent Cat Wise has our report for our weekly series on the Leading Edge,of science.,CAT WISE: Three-point-five million Americans are living with a potentially deadly virus,,and half dont even know it.,Its hepatitis C, a blood-borne pathogen which attacks the liver and can eventually cause,serious liver problems, including cirrhosis and liver cancer.,Three-quarters of those with the virus are baby boomers, exposed from unscreened blood,transfusions, I.V.,drug use, and other blood-to-blood contact prior to the early 90s.,But now the opioid epidemic has led to a 20 percent rise in new infections from 2015 to,2016.,One state where the young and the old have been hit hard by the disease is Oregon.,Oregon has the highest hepatitis C mortality rate, per capita, in the country.,Its estimated about 100,000 Oregonians have been infected with the virus and more than,500 die every year.,Its been a very difficult disease to treat, but over the last four years, theres been,a revolution in hep C drugs.,Many are being cured around the country now, and here in Oregon, many are coming here to,the Oregon Clinic for those treatments.,DR.,KENT BENNER, The Oregon Clinic: We never talked about cure of hep C until the last few years,,and now were all talking about cure of hep C.,CAT WISE: Dr. Kent Benner is a gastroenterologist and hepatologist at the clinic in Portland.,He says people are still dying from the disease, often because they havent been tested and,arent aware they have virus until they are quite sick.,But Benner says much has changed since he first started treating patients several decades,ago.,DR.,KENT BENNER: Treatment at that time was interferon.,This required injections, shots several times a week.,Quite a few side effects.,We felt we were doing well if we could cure 15 or 20 percent of patients.,Since late 2013, theres been a remarkable development from a number of different companies.,They have developed drug combinations that provide 95 percent cure rates in patients,we treat.,CAT WISE: Costly liver transplants are often the only option when the liver becomes too,badly damaged.,But at earlier disease stages, the liver often starts to heal once the medicines have cleared,virus from the body.,DR.,KENT BENNER: Not only are we seeing liver function improve, but patients with more advanced,liver disease occasionally can come off the transplant list.,CAT WISE: Sixty-four-year-old Rob Shinney, who recently had knee surgery, is one of those,cured by the new hep C drugs known as direct-acting antivirals, or DAAs.,Like many others of his generation, he doesnt really know how he contracted the virus.,Under the care of Dr. Benner, Shinney began a three-month treatment in late 2016 after,his liver showed signs of moderate scarring known as fibrosis.,Tests later confirmed he was virus-free.,ROB SHINNEY, Patient: I had a serious chronic illness hanging over my head that I knew could,kill me.,And thats gone now.,CAT WISE: We spoke at a local pub he visits now and again with his choir friends, something,he never did when he had the virus.,ROB SHINNEY: I swear I felt like I was 20 years younger.,I had energy.,I could do things.,Its great just to be able to sit around and have a beer with everybody and, you know,,just enjoy life.,CAT WISE: The cost of the drugs used to cure Shinney, who has private insurance, arent,cheap.,Since Gilead Sciences Sovaldi first hit the market in late 2013 at a whopping $84,000,for a course of therapy, competitors have steadily lowered the costs.,Last year, a new medication called Mavyret was released for around $26,000.,Many payers often, though, negotiate even lower prices with the drug company.,Still, the drugs are expensive, and they arent a vaccine.,If someone is cured, they can become reinfected.,Access to the drugs varies widely around the country.,A report last year by two national advocacy organizations found that many public and private,payers choose to limit access to DAAs due to their cost, as well as other concerns.,Oregon is among a number of states which have had restrictive Medicaid requirements, including,denying coverage to patients in the early stages of disease and those who are abusing,drugs and alcohol.,But some of those restrictions are beginning to ease.,DR.,DANA HARGUNANI, Oregon Health Authority: In January, we just started covering individuals,with lower stages or lower levels of fibrosis.,CAT WISE: Dr. Dana Hargunani is the chief medical officer for the Oregon Health Authority,,which oversees the states Medicaid program.,She says, while the state is starting to expand access, costs are still a significant issue.,Oregon has spent more than $94 million on the drugs since 2014, covering about 1,500,people.,DR.,DANA HARGUNANI: The newer treatments for hepatitis C have a significant budget impact for our,state.,We had to get additional funding through the legislative process.,Were trying to manage our limited resources to ensure coverage for those who need it immediately,for the hepatitis C treatment, as well as all the other individuals in our Medicaid,program.,CAT WISE: Hargunani says another reason the state delays coverage until patients have,mild liver scarring, not everyone needs the medicines.,DR.,DANA HARGUNANI: One in five individuals who get infected with hepatitis C will spontaneously,clear their infection.,Right now, the data doesnt help us understand how to know which individuals will need to,have a high-cost drug to treat and cure their infection.,DR.,BRIANNA SUSTERSIC, Central City Concern: Luckily, he doesnt have any evidence of cirrhosis.,CAT WISE: Dr. Brianna Sustersic is a medical director at Central City Concern, a federally,funded health center in downtown Portland which serves a large number of homeless individuals,,many of whom have substance abuse disorders; 25 percent to 50 percent of the patients have,hep C.,DR.,BRIANNA SUSTERSIC: The Medicaid requirements have limited access to treatment for many,of our patients.,From a public health standpoint, if we are able to treat the population who is contracting,this, and spreading it, then we can move toward eradicating the disease.,CAT WISE: To prove that point, and to meet a big need, the clinic and a local syringe,exchange program began a small drug company-sponsored study last year to treat patients who otherwise,wouldnt have qualified for the medications; 56-year-old Kim Trano is now virus-free thanks,to that trial.,She says shes felt a lot of stigma being a recovering drug user and it was hard to,learn she had initially been denied drug coverage.,To those who would question giving expensive medicines to someone who might become reinfected,,she says:,KIM TRANO, Patient: Everyone is worthy of a chance.,If I were to relapse, I would all precautions not to be reinfected.,And thats pretty easy to do.,Most people know how to do that.,CAT WISE: The new medicines combined with the big surge in those looking for treatment,has led to a unique care model.,Chris Hulstein is not a doctor.,Hes a clinical pharmacist and part of a new program at Portlands Providence Hospital.,Over the past year, about 50 patients have been successfully treated by Hulstein and,his colleagues.,Another 30 are currently in treatment.,CHRIS HULSTEIN, Clinical Pharmacist: A lot of the specialists are very busy managing,very complex patients, and that is their role.,Having a pharmacist being able to manage the patient gets patients treated faster and more,successfully than we ever have been able to do before.,CAT WISE: Hepatitis C advocates are now working with