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 Amazon.ca and Amazon.com. 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:

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

Gibsons
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.

The liver is important–so get out the hep C testing message

As Hepatitis Awareness Month continues, it’s time to think more about testing for hepatitis C. The disease is curable, but the liver, if too severely damaged, is not.

Everyone who has hep, had hep, works with people who have hep C or is reading this blog because of other interests, should pass the testing message along. It’s vital, just like the liver.

Hepatitis C ravages the liver. It’s symptoms usually creep up sluggishly and at first, imperceptibly. That’s why most people with the chronic form of the disease don’t know they have it. That’s why feeling symptoms of hep C should not be the only reason to be tested.

Being a baby baby boomer or suspecting you have been in contact with someone else’s unscreened blood should be the reason.

You can’t live without a liver. It filters blood, removing harmful substances, such as alcohol. It manufactures proteins that defend against infection and help the blood to clot. It regulates the supply of vitamins, minerals, and hormones, including sex hormones. It produces, stores, and regulates glucose and fat. It makes and eliminates cholesterol and also converts it into lipoproteins that deliver energy to the cells.

Altogether, the liver performs more than five hundred bodily functions. It continues to do these jobs during the early stages of hep-caused fibrosis, and early on it can recover fully from damage. Later, when the liver hardens into cirrhosis, it progressively loses important abilities. When the damage becomes severe, liver cancer or a liver transplant are common results.

So no one should risk this vital organ, whether they have symptoms of hep C or not. It’s easy to get tested. Just ask your doctor–or ask your friends to ask theirs.

Cured of hepatitis C? Watch your cholesterol

Hepatitis C may have done one good thing for me. It may have lowered my cholesterol for a while–or maybe being cured ramped it up.

In a 2009 study from Massachusetts General Hospital, researchers found that a significant number of people who are cured of hep see their LDL (low density lipoprotein, known as bad cholesterol) “rebound to levels associated with increased coronary disease risk.” That seems to have happened to me. My cholesterol was on the low side of normal before my treatment, but after the virus cleared it jumped into the danger zone. Here’s a chart I obtained from my ehealth, a website that reports on patients’ medical tests in British Columbia:

The chart shows an early 2014 blood test I had  before I was treated with direct-acting antivirals that summer. The next three dots on the chart show my bad cholesterol after my treatment and cure.

I may have inherited a propensity to high cholesterol from my dad. He died of heart failure, and I have no other risk factors. Perhaps, as research suggests, hepatitis C may have lowered or stabilized my inherited build up of cholesterol. The liver eliminates cholesterol through bile, and the liver changes after treatment. There’s a possibility that my liver, which regressed from fibrosis, never regained strength in cholesterol clean-up.

I’m no longer worried about my liver, but I’m worried about my heart. It’s time to get out and exercise, get rid of fatty food, and keep on top of this new health risk. Those who have been cured of hepatitis C still need to be tested–for cholesterol.

 

New Helpline Established for British Columbians with Hep C

Peer-to-peer counselling for people with hepatitis C has been available in the United States for several years. Now people in British Columbia have their own help line through the Pacific Hepatitis C Network.

This is great news for Canadians who have hepatitis C and want to talk with someone who has had their own experience with the disease. The toll free number for British Columbians is 1 888 411 7578. Ask for Daryl Luster.

For the U.S. helpline, please call 877-435-7443.

May is on the way with hepatitis C awareness

May is Hepatitis Awareness Month. As the month begins, it’s a good time to mark your calendar with an important date. May 19 is Hepatitis Testing Day.

As a reader of this blog, you’ve probably already been tested. Many readers are dealing with their own virus or have friends who have hep C. Other readers are medical professionals, and still others, I’m glad to say, have been cured.

But not everyone has. You can’t be cured if you don’t know you have hep. Let’s all try to mark the month by thinking of those who have yet to be tested, especially Baby Boomers. Please tell your friends about the month and the testing day.