The Pulse
4:37 pm
Mon April 21, 2014

Hep C: Who Gets New, Better Drugs, And Who Waits?

A few health care organizations are trying to grapple right now with the great news that, on the one hand, new hepatitis C treatments are more effective and more tolerable for patients; on the other, they're so expensive they can't figure out how to treat everyone who's infected. How expensive? $1000 a pill, one pill a day. One pill a day that doesn't make you sick is music to the ears of people who've been on the older treatments. But the new treatment is at least 12 weeks, at $1000 a day, and insurers are starting to balk.

Here's a great rundown from Kaiser Health News' Julie Appleby on what the Veterans Affairs Administration and a California health panel are recommending in terms of who gets the treatment.  In a nutshell, the recommendations are that the sickest patients, those with advanced liver disease, for example, get the new drugs. Because you can have a hepatitis C infection for decades, sometimes, before ever showing symptoms, the thinking is that the less sick can wait. New treatments, even better, are in the pipeline now that should be available for them soon.

But with an estimated three to five million people infected with hepatitis C in the U.S. now, according to the CDC, and more likely to emerge as baby boomers age and recent IV drug users get new infections, it's not clear our health system is ready to handle the influx. The CDC has urged baby boomers, in particular, to get tested, because they're five times as likely to be infected than other age groups (from drug use in the 60s or 70s, or from blood transfusions or other medical procedures done before more stringent surveillance of the blood supply was in place).

In Rhode Island, the health department estimates about 21,000 Rhode Islanders are infected. Treating them all with a 12-week course of the new drugs would bankrupt health claims payers. So health care providers and policymakers are going to have to come up with a plan of some sort until there are cheaper, as effective meds. On a positive note, the new drugs have a very good chance of curing patients. And to be cured of hepatitis C is to be spared a potentially horrible, slow death from the disease's painful complications.

Interested in learning more about hep C? I recommend checking out RIdefeatshepc.org.

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