Wednesday, October 25, 2017

VA Responds To Concerns About Collaboration With ICER

VA Responds To Concerns About Collaboration With ICER
C. Bernie Good ,Tom Emmendorfer, Michael Valentino
October 25, 2017

On June 27, 2017, the nonprofit Institute for Clinical and Economic Review (ICER) announced that it was collaborating with the Department of Veterans Affairs (VA) Pharmacy Benefits Management (PBM) Services to “support VA coverage and price negotiations with pharmaceutical companies to promote access to high-value drugs.” This announcement has generated quite a bit of interest---some enthusiastic, and others, not so much....

Regardless of the nuances regarding formulary status, the real question should be whether veterans have access to medically necessary medications, as part of the VA’s overall medical care system. And the fact is, veterans generally get similar or better care compared to other health care systems, as reported by a recent independent RAND Corporation study. Consider the case of hepatitis C drugs. The VA has most of these drugs included on the VA National Formulary, and the maximum prescription copayment for any veteran is $11 per month. Compare that to Medicare Part D beneficiaries, whose annual average copayment for the hepatitis C drug Harvoni can exceed $7,000. As of August 2017, 66 percent of veterans with hepatitis C have been treated with these new and effective drugs---almost certainly a far higher percentage than any other health care system in the United States....

Read the article - 

Opioid addiction and the most controversial bathroom in New York

Opioid addiction and the most controversial bathroom in New York
By Dr. Sanjay Gupta, Chief Medical Correspondent
Updated 12:25 PM ET, Wed October 25, 2017

Mata's infirmary is the Corner Project, a syringe exchange program that began operating in the New York neighborhood of Washington Heights, which houses a bathroom where drug users can more safely inject heroin.

Watch Video, or read the article at CNN online 

HCV Support Online - Watch Stories Shared By People Affected By HCV

Video Vignettes: Through Their Own Lens: Hepatitis C Virus Liver Disease
October 24, 2017
Roughly 3 to 4 million people in the US are infected with hepatitis C virus (HCV). And 75% of them are Baby Boomers. Thirty-five to 40% of liver transplants in the US are the result of HCV cirrhosis. 

We continue our Video Vignettes series by introducing you to a member of the American Liver Foundation Support Community on Inspire who is living with a liver transplant caused by HCV. If you or a loved one has liver disease, go to and join the American Liver Foundation Support Community on Inspire.

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American Liver Foundation Support Community on Inspire.
Liver disease support group and discussion community.

View All: Video Vignettes in this series

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Clinical Care Options - Why Do We Believe HCV Elimination Is Possible?

Comprehensive coverage of the Liver Meeting over at CCO is just getting started, however today a Video Module reviewing critical steps needed to eliminate hepatitis C in the United States is available for download. 

Video Module
Why Do We Believe HCV Elimination Is Possible?
Watch and listen as Jordan J. Feld, MD, MPH, and Natasha Martin, DPhil, discuss what makes achieving HCV elimination feasible: targeting at-risk populations, delivering multiple interventions, and personalizing interventions to optimize outcomes by risk group.
Faculty: Jordan J. Feld MD, MPH, Natasha Martin DPhil
Released: 10/24/2017

Content is free for everyone to view, but you are required to log in as a registered user. Registration is quick and free! Register (LINK)
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On Twitter - The Liver Meeting
Through an online file sharing platform, "Henry E. Chang‏" tweets out daily information about viral hepatitis, in addition to key data presented at the meeting this week, allowing us to view, download or share current HCV research.

Recently tweeted by "@HenryEChang" on the topic of HCV elimination:

Data presented at LiverMtg17 by my @nycHealthy colleagues on NYC hospitals' capacity to support HCV elimination→

Hepatitis C treatment as prevention: Modeling the scale-up needed —Dr. Natasha Martin→

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Gilead’s Patents on Hepatitis C Drug Challenged by Consumer Group

By Susan Decker and Cynthia Koons
‎October‎ ‎25‎, ‎2017‎ ‎8‎:‎01‎ ‎AM‎ ‎EDT

Group says patents have blocked access to life-saving medicine
Pricey hepatitis C treatment has been a top seller for Gilead
Gilead Sciences Inc.’s U.S. patents on the blockbuster $84,000 hepatitis C treatment Sovaldi were challenged by a consumer group that’s battled the drugmaker around the world over the pricing.

The Initiative for Medicines, Access & Knowledge, a nonprofit focused on how patents affect access to medicine, said that it’s filed petitions with the U.S. Patent Trial and Appeal Board seeking to challenge intellectual-property rights that would keep generic versions of Sovaldi from entering the market.

Read the article at Bloomberg

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The controversy over expensive new drugs for hepatitis C
Link to research and news articles addressing the high cost of hepatitis C drugs; insurance restrictions - private insurers/Medicaid - and availability of generic versions/India, Egypt and other lower-income countries or through online "buyers clubs" 

Hepatitis C care falling short for young opioid users in R.I.

Scourge of a new generation
A rendering of the
hepatitis c virus,
which can linger unknown
for decades before
causing severe liver damage.
Hepatitis C care falling short for young opioid users in R.I.
New research finds that while many Rhode Island young adults who use opioids get screened for hepatitis C, they aren’t always connected to care for an infection if one is detected.

PROVIDENCE, R.I. [Brown University] — As public health officials worry that the increase of opioid use among young adults has helped to spread the hepatitis C virus to a new generation, a study in Rhode Island finds that while screening is common, the follow-up measures needed to stop the spread of the virus are significantly less so.

Hepatitis C virus (HCV) can linger for decades before causing any symptoms, but eventually it can severely damage the liver, leading to death without treatment.

“Many young people who are at risk for hepatitis C may acquire the infection and then not know it, and then through drug injection practices may transmit it to others,” said Brandon Marshall, associate professor of epidemiology in the Brown University School of Public Health and corresponding author of the new study in the Journal of Adolescent Health. “For this reason, we need to not only be screening, but also providing care to young people who test positive for hepatitis C.”

Between January 2015 and February 2016, the researchers recruited 196 people between the ages of 18 and 29 from the streets of Rhode Island who use prescription opioids recreationally, rather than for medical reasons. Of those, 154 (78.6 percent) reported receiving HCV screening, which Marshall said was a high and encouraging rate. That said, the proportion receiving screening was much higher among those ages 24 to 29 (89.5 percent) than among those ages 18 to 23 (59.7 percent), he noted.

Among those who were screened, 18 said they tested positive for HCV, which was 30 percent of the 59 people in the study who said they have injected drugs. When study staff asked about follow-up care, they found several gaps: Among the 18 with a positive test, 13 received a confirmatory follow-up test, 12 were referred for specialty care, only 10 received information about how not to transmit the virus to others, and nine received education about living with HCV.

“Screening for HCV is free in many parts of the state, but financial and other barriers exist for youth who test positive and are in need of additional resources and hepatitis C care,” Marshall said. “We need to work on improving access to hepatitis C treatment programs and other referral services for young people.”

Co-author Dr. Lynn Taylor, an associate professor of medicine at Brown and physician at the Miriam Hospital, said the clear overlap of opioid use and hepatitis C infection requires a tightly coupled public health effort.

“This work points to our next steps: We must act to integrate overdose and hepatitis C prevention in Rhode Island,” Taylor said. “In locales where people are injecting opiates, there are an estimated five new hepatitis C infections for every fatal overdose. Rhode Island is the ideal state to address the connections between the opioid and hepatitis C crises and demonstrate the benefits that are possible for public health preventive efforts.”

Brown University School of Public Health graduate alumnus Ayorinde Soipe led the study. Other authors include Ajibola Abioye, Traci Green and Dr. Scott Hadland.

The National Institutes of Health funded the Rhode Island Young Adults Prescription Drug Study (grant R03-DA03770), from which the data were derived, and provided additional funding (P30AI042853).

Tuesday, October 24, 2017

Surgeon General: We will conquer HCV, opioids ‘one bite at a time’

Surgeon General: We will conquer HCV, opioids ‘one bite at a time’
During a session focused on the connection between the hepatitis and opioid epidemics at The Liver Meeting 2017, Jerome M. Adams, MD, MPH, Surgeon General of the U.S., advised physicians in attendance that hepatitis C elimination will require nontraditional partnerships and innovative strategies for education, prevention and screening.

“I want to ask you all a question that I hope all of you know the answer to,” Adams said to the audience. “How do you eat an elephant? One bite at a time. If you take one bite at a time, if you help all of our partners see which part of that elephant they can take a bite of, we will be able to consume that elephant that is the opioid epidemic.”

Read article available online at Healio

The Liver Meeting® 2017- Conference Coverage
WASHINGTON — In this exclusive video from The Liver Meeting 2017, Arun Sanyal, MD, FAASLD, from the Virginia Commonwealth University…

October 23, 2017
WASHINGTON — Through treatment of hepatitis C genotype 1 with direct-acting antivirals, significant direct and indirect cost savings may…

View More Conference Coverage From - "Healio"

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October Series From HCV Advocate - HCV and Peripheral Neuropathy

New Online: HCV-related diseases

In October, HCV Advocate launched a series of patient-friendly articles about the Extrahepatic Manifestations of Hepatitis C, written by Alan Franciscus.

Browse through topics provided below, make sure not to miss new articles published later this month, sign up here to receive updates, follow HCV Advocate on Twitter or connect on Facebook. Find out what's new, here!

Begin with HCV Advocates Extrahepatic Manifestation Glossary and Fact Sheets.

October Blog Special
Extrahepatic Manifestations of Hepatitis C—Peripheral Neuropathy | Alan Franciscus
October 24, 2017
In the past, peripheral neuropathy was believed to be confined to people only infected with hepatitis C-related cryoglobulinemia, but now it is known that peripheral neuropathy may occur even in the absence of cryoglobulinemia.
Continue reading (LINK)