Real World Health Care Blog

Tag Archives: hep c

Hep, hep, hooray!

Editor’s Note: As we come to the conclusion of Hepatitis Awareness Month, we are pleased to share with our readers a column written by Gene Weingarten of the Washington Post. Gene Weingarten is a Pulitzer Prize-winning journalist and writes “Below the Beltway,” a weekly humor column that is nationally syndicated. The column initially appeared online on May 21, 2015.

As far as helping to erase the unfortunate stigma of the disease, I fear my personal story may not be of much value. While it is true that many hep C victims become infected through blood transfusions or organ transplants, or in other innocent ways, mine was contracted during my college years, when I showed as much care for my personal health as your average suicide bomber. I got hep C because of my appetite for altered states of consciousness, which is a highly dignified way of saying that I enjoyed sticking needles in my arm to facilitate nodding and drooling.

HepatitisAwarenessMonthBecause of modern medicine I no longer have hep C, but in a sense, I am still “living with it.” That is because most every time I get blood drawn for any reason, the results arrive with a gigantic warning that I have hepatitis C. (As it happens, once you have the disease, the telltale antibodies in your blood hang around forever, like your wife’s doofus brother Duane.) For the instant until you remember this fact, the medical news is terrifying, but even afterward you are dispirited. It’s like having one of those suggestive small-of-the-back tattoos, the occasional glimpse of which reminds you that you were once a stupid dirtball.

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A message from our sponsor: If you or someone you love is living with Hepatitis C and is struggling to afford the treatments, the HealthWell Foundation may be able to help. Click here to visit HealthWell’s eligibility page.

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I know that hep C is a particularly insidious scourge, since many people who have it are asymptomatic for a long time, meaning they don’t know they have it, meaning the disease often progresses without treatment for far too long. If you were ever at risk, get tested! I can testify to the wisdom of this because of how I was diagnosed.

I discovered that I had it, and that I’d had it for two decades, only by accident, after going to the doctor following a startling grease-related bodily event that caused me to have to leave work and buy a new pair of pants. (I am telling this here because of my deep commitment to disseminating important medical truths during Hepatitis Awareness Month, and because, as a humor columnist, I have no remaining sense of shame.) My grease problem turned out to have been benign, the result of a single binge episode of eating peanut butter from a tablespoon. This would have been deeply reassuring, except the doctor then told me that something else had shown up in the blood work. “Something else showed up in the blood work” is one of those things that is not good to hear, like a concerto for flugelhorn, vuvuzela and cowbell.

But in the end, my experience with hepatitis C is that I got over it, which I hope will be an inspiration for readers of this blog. It is true that my cure came only after injections into my thighs three times a week for nine years, but this should not be discouraging.

First, the treatment is easier now. Second, the life-or-death uncertainty with which I was living provided philosophically beneficial. For nine years I embraced life as never before, becoming more responsible, more appreciative, a more sober and serious person.

Then I got cured and forgot about all that crap. Win-win!

Targeted Therapies Open Door to Improved Outcomes and Lower Costs to Treat HCV

As we were reminded on World Hepatitis Day, early detection is critical to turning the tide of this “silent epidemic” that impacts millions. However, strategies to end the deadly effects of viral hepatitis don’t stop there. Personalized treatment is another essential tool that fuels better outcomes for patients with hepatitis C (HCV) while saving money in the long term for the health care system too. 

Paul DeMiglio

Paul DeMiglio

The importance of finding effective therapies for HCV is underscored by the reality that the disease often goes undetected, with an estimated 80 percent of Americans with HCV unaware of their status. Many HCV-positive people show mild to no symptoms, making it more likely for the illness to progress and become more expensive to treat as a result. 

Although safe and effective vaccines are available for hepatitis A and B, none exist for HCV. To help answer this need, Abbott created the fully automated RealTime HCV Genotype II Test – the first FDA-approved genotyping test in the United States for HCV patients – to facilitate targeted diagnosis and treatment that boosts desired outcomes.

This treatment-defining genotyping test empowers physicians to better pinpoint specific strains of HCV, determine which treatment option is best for the patient, and make more informed recommendations about when it should be administered. Available to individuals with chronic HCV, the test is not meant to act as a means to screen the blood prior to diagnosis.

So how does finding the right HCV treatment save money?

Targeted therapies like these are important for diseases like HCV because they reduce the “trial and error” of having to use additional treatments when the initial ones don’t work, saving money and time for patients and providers. Early detection, combined with follow-up care, can prevent patients from developing later stages of hepatitis that can mean more serious long-term conditions that are harder and more expensive to treat.

Treating HCV patients with end-stage liver disease, for example, is 2.5 times higher than treating those with early stage liver disease. Advanced HCV can also escalate to chronic hepatitis infection, a side effect of this being cirrhosis (scarring of the liver and poor liver function) and liver cancer. Treatment for these two conditions (which can include a liver transplant) can cost more than $30,000. Liver cancer treatment can be more than $62,000 for the first year, while the first-year cost of a liver transplant can be more than $267,000.

As more and more patients find themselves unable to afford treatments, HCV is becoming an increasingly larger financial burden on the health care system.

The annual costs of treating HCV in the United States could be up to $9 billion, and over the course of a lifetime the collective cost associated with treatments for chronic HCV is estimated to total $360 billion.

“As we see patients with more advanced liver disease, we see significantly more costs to the system,” says Dr. Stuart Gordon, author of the Henry Ford Study. “The key, therefore, is to treat and cure the infection early to prevent the consequences of more advanced disease and the associated economic burden.”  

Targeted therapies show great promise to improve outcomes while saving time and money by linking patients to the specific treatments they need at earlier points of diagnosis. But what can health systems do to make innovations like the HCV Genotype II Test accessible to more patients and increase the cost-savings benefit on a larger scale?