British Columbia approves hep C treatment for all

The province of British Columbia has just made treatment for hepatitis C available to all of its residents. Previously, the B.C. government rationed treatment according to a patient’s degree of fibrosis.

Health Minister Adrian Dix

Health minister Adrian Dix announced this news today, stating, “I’m pleased to share that as of today, anyone in B.C. living with this now-curable virus will have a choice of several treatment options — all of which are fully funded under PharmaCare.”

Vosevi, Gilead Pharmaceutical’s new treatment for hepatitis C, became available for British Columbians through PharmaCare this week. Ontario approved the drug last week under its similar government-run drug plan.


Full availability of treatment was long awaited. I live in British Columbia. When I was diagnosed four years ago, the cost of the early direct-acting antivirals was more than $100,000. No Canadian province would pay for them. I was lucky to have one of the best employer-paid medical plans in the country, so I was treated. But most people infected with hep C back then had to wait for treatment, often for years.

Now people just need to be tested and cured. Some 73,000 British Columbians are still infected with hepatitis C. The time for their cure is now.



Holiday thoughts about hepatitis C and its cures

It’s odd that during the holiday season, after three years after being cured, I still think about hepatitis C. Many years ago, a blood transfusion that saved my life may have been the route to my disease. Or my infection may have been the result of a horrendous incident with bikers. Or perhaps there was transmission in my family, when I was young.

Twelve weeks of two of the earliest direct-acting antivirals led to my SVR in January 2015, but the puzzle of my infection lingered.

I decide to investigate. That led to a book about my journey with the disease and the pharmaceutical research that led to anti-viral cures. This past summer, Greystone Books published Demon in My Blood.

I thought that getting my story out—in a big way—would end my thoughts about the disease. Yet I continue to worry about my liver. It has regressed back to normal, from being near cirrhosis during my infection. That gives me confidence, but not certainty.

I slipped walking on the beach this fall and then felt a pain in my side. It kept me awake at night for more than a month. I wondered whether the pain was not actually a bruise or a torn rib. Might it have been some residual damage to my liver?

Entering the holiday season, I worried about parties I would attend. I had gone back to having a glass of wine now and then about a year ago. But it’s too easy to accept a refilled glass when someone carries a bottle to the table offering another round. Would another glass be good for me? Would there be unknown jiggers of vodka in the punch?

Occasionally I just get pain in the right side. But I have digestive problems unrelated to hep, which can create pain that seems like it’s coming from the liver. My doctor said to see him if the pain becomes steady.

So I continue to worry about hepatitis C, and I keep to a healthy-liver diet. But the good news is and always will be that I’ve been cured of hep C—and that cures are available for everyone, once they are diagnosed.

Every year more people are cured–and 2018 should see a decrease in the number of infected people worldwide. That’s good news for the new year. May you have a happy one.

$5 HCV drugs may be affecting profits

Gilead Sciences in its second-quarter report for 2017 reported that its sales of direct-acting antivirals for HCV were down about 25 percent from the same period last year (2.9 billion, compared with 4 billion). Does this mean that fewer cases of HCV are being treated, or does it mean the prices of antivirals are going down?

It’s hard to compare the prices because the company is secretive about its negotiations with insurance companies and governments. When the drugs were first on the market, wealthy patients were shelling out upwards of $100,000 for the drugs. Now, except for uninsured people or those on Medicare or Medicaid, Gilead is advertising a $5 bargain price for the drugs. Considering the exclusions, that doesn’t seem like charity, but it may be keeping Gilead’s cash coffers down.

As for the numbers of people being treated, the latest report from the World Hepatitis Alliance shows they’ve more than doubled since 2013, when 440,000 people were treated, mainly with interferon.

Hepatitis drug coverage in English-speaking countries

Today I have a few updates about drug coverage in some English-speaking countries:

  • For more than a year in Australia, the government’s Pharmeceutical Benefits Scheme has been charging low-income patients $5.30 for treatment with direct-acting antivirals. Other Austrailians pay only $37.80 for a treatment. A family physician or nurse practitioner can prescribe the drugs in consultation with a gastroenterologist or hepatologist specialized in chronic hepatitis C infection.
  • Residents of the United Kingdom await better coverage of drug costs for hepatitis C. Last year the National Health Service limited its coverage of the hep C miracle cures to 10,000 patients per year, whereas 160,000 people in the UK were infected with hepatitis C. A spokesman for the NHS said, “As prices come down we hope in future years to be able to expand treatments even further. . .”
  • Canada, where each province runs its own drug plan, has been seeing better coverage for hepatitis C antivirals. British Columbia, for example, has announced that treatment for everyone with hepatitis C, no matter their degree of liver damage, will be covered by its Fair PharmaCare plan starting in 2018. Under the plan, patients pay a deductable, depending on their income. After paying the deductible, they pay 30 percent of drug costs to a maximum amount. At that point the plan pays everything. For example, a hepatitis C patient with a family income of $50,000 a year would pay a total $1,650, including the deductible and 30 percent payment. The plan would pay everything after that.
  • In the United States, drug plans and Medicaid may not cover hep C treatment for all levels of fibrosis. The big worry there recently has been the repeal of the Affordable Care Act and the Senate’s proposed replacement, which could allow States to alter their rules so that pre-existing conditions may preclude coverage. Hepatitis C can hide in the system for decades, until it emerges as a pre-existing condition.

Blog readers, please let me know the news from your location.

Book about Hepatitis C now available, will talk about Demon in My Blood at May & June events

Demon in My Blood is off the press, in book stores and on and The book tells the story of my bout with hepatitis C, my cure, the development of direct-acting antivirals, the accessibility of the drugs, and the quest to learn how I acquired the disease. Demon in My Blood can be read as a history of medical innovation, a patient-experience chronicle, or a mystery. It’s also a cry for widespread testing.

The book will be launched in two locations:

Wednesday, May 31, 2017, 7 pm
Book Warehouse
Main Street and King Edward Avenue

Friday, June 16, 2017, 7 pm
Truffles Cafe
264 Gower Point Road

I’ll be reading and speaking about the book. There will be light refreshments and a door prize at each location. I hope to see you there.