Tuesday, December 23, 2014

Even with New AbbVie Drug, Many Hepatitis C Patients Are Being Turned Away from Treatment

Even with New AbbVie Drug, Many Hepatitis C Patients Are Being Turned Away from Treatment

Expensive medications to cure hepatitis C have far fewer side effects than the drugs that came before, but getting insurers to pay for them is an uphill battle.

Written by David Heitz | Published on December 22, 2014

Hundreds of thousands of Americans this holiday season wish for nothing more than to “slay the dragon.”

That’s what they call getting rid of the hepatitis C infection raging inside them. “The dragon” saps their energy as it slowly causes cirrhosis, or scarring of the liver. For many, it has done so for so long that they’ve forgotten what it feels like to be healthy.

Now there are ways to kill hepatitis C, or HCV infection, for good without putting people who have the disease through too much agony in the process. But these cures, which are about 90 percent effective, are expensive.

Doctors, insurance companies, and even governments have cried foul over high prices the new medications Sovaldi, Harvoni, and now Viekira Pak. Sick people aren’t getting the treatments they need due to insurance denials and other roadblocks. That angers Dr. Douglas Dieterich, Director of Outpatient Hepatology at The Mount Sinai Hospital in New York City.

“Waiting for cirrhosis to happen to treat HCV is like waiting for cancer to metastasize, or for diabetes to cause complications before treating it,” Dieterich told Healthline. “In reality, all cause mortality, and per patient per year healthcare costs are tripled for patients with hepatitis C, whether they have cirrhosis or not. Clearly, insurers don't understand this. They only tend to worry about the death from liver disease or the liver transplant, which can cost as much as half a million dollars.”

Learn More: New Hep C Drug Sovaldi Ignites Fierce Pricing Debate »

Hepatitis C is transmitted mostly through blood-to-blood contact. It usually progresses very slowly, and it can take decades before symptoms appear. Of the more than 3 million Americans infected with hepatitis C, many if not most don’t know they have it.

Treatment options other than Sovaldi, Harvoni, and AbbVie’s new Viekira Pak can be extremely uncomfortable. While insurers are quicker to approve more inexpensive treatments such as interferon and ribavirin, the medications can have brutal side effects. Interferon causes nausea and depression; ribavirin ramps up agitation.

Dieterich said he saw patients last week who’ve finished a 24-week course of Sovaldi. “They’re just glowing with health. They had [hepatitis C] for 30 years and they didn’t realize how bad they felt. When it goes away, it’s, ‘Oh my God, I forgot what feeling good felt like.’”

Evidence Shows More People Need Treatment

Lucinda Porter, a nurse, patient advocate, and hepatitis C survivor, points to research presented at The Liver Meeting in San Francisco last month as proof that people aren’t getting the help they need.

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