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Hepatitis C kills more Americans than all other infectious diseases combined

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Re: Hepatitis C kills more Americans than all other infectious diseases combined

#151

Post by gnopgnip »

ethbro wrote: post #83
shaftoe wrote: post #12

I get their point about stigma, but as someone who has never injected drugs, I'm having a hard time caring about getting screened for this. How do they intend to actually roll out a massive testing operation (everyone under 80) when likely most people hear the details and respond with "meh, not me"?

From a public health perspective, recommendations and guidelines like this drive insurance company policies and government funding priorities. Or in other words, the things that actually move the needle when you're trying to get something done for an appreciable percentage of citizens. There's no ability and need to test everyone today, but this is a sign that we should move to more regular screening of higher percen…

The blocker is generally the cost associated with false positives. If you are low risk for hep C and you get a positive test result it is more likely than not a false positive

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#152

Post by inasio »

trimbo wrote: post #15
yakz wrote: post #2

Antiviral drugs for hepatitis C are very effective, but they come at a steep cost. Just one Sovaldi pill costs $1,000. A full 12-week course of treatment with this drug costs $84,000. The price of other hepatitis C drugs is also high: Harvoni costs $94,500 for a 12-week treatment Mavyret costs $39,600 for a 12-week treatment Zepatier costs $54,600 for a 12-week treatment Technivie costs $76,653 for a 12-week treatmen…

They're priced this way because they're 80-90% cheaper than the previous treatment. Previously, with no cure, HepC patients would have eventually had a liver transplant. Liver transplants cost between $500K-$1M. Of course, it also requires a liver, so many would die waiting for a liver. As you noted, the drugs have become much cheaper. Mavyret is ~1/2 the cost of Sovaldi, the first drug on the market (replaced by Har…

I used to do research on HCV. HCV was curable for at least 10 years prior to Sovaldi, the issue was that the Ribavarin and peg-interferon treatment typically took 48 weeks, had a cure rate around 50% at best if you had the right HCV genotype, and had many adverse effects. The epidemic is currently being driven (at least in western countries) by active drug users, treating them with that regime was simply not possible.

Contrast that with 8 weeks or less of 1 pill per day (and possibly less), with no side effects, pangenotypic and >95% efficacy for all (including cirrhotic individuals, HIV co-infected, etc)

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#153

Post by inasio »

coder1001 wrote: post #20
dd36 wrote: post #8

Earlier quoted context omitted.

There’s a $300 treatment on the way: https://www.dndi.org/2018/media-centre/press-releases/new-af...

or go to India now and be treated for $1k [1]? [1] https://www.medicaltourismmag.com/article/hepatitis-c-treatm...

At least a couple of years ago there were so many treatments on the pipeline that it was probably doable to find a phase 3 trial that would take you in.

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#154

Post by hypewatch »

Hep C is a curable disease that doesn’t have any symptoms. It also tends to infect the most vulnerable among us - heroin addicts.

So the root cause of this issue is not the disease itself but our society and health system. These victims are not receiving the testing and treatment they need because they choose not to or (more likely) can’t afford to go to the doctor.

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#155

Post by pagutierrezn »

0xB31B1B wrote: post #101
deith wrote: post #89

Earlier quoted context omitted.

Pro-tip: it doesn't actually cost $500K-1M to transplant a liver (which you get for free).

It costs an insane amount of money. 1) there is a large infrastructure around organ donations that needs to be maintained 2) it generally requires the organ (and some times doctor) to be flown on a private jet from where the organ comes from to the person receiving the transplant 3) transplant surgery is a very long procedure requiring multiple specialists 4) recipient is on a lifelong course of drugs (literally like…

I'm a little bit surprised about these comments. One of my friends is a doctor at a Hospital in Bilbao with 30 years of experience. He tells me that this is the first year he has seen livers availabe for transplant that were not transplanted because no patient needed them. His argument is that more and more hepatitis C patients are receiving the antivirals and do not need a transplant anymore.

May be someone has data from other European countries with a strong public health sector

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#156

Post by quaquaqua1 »

carapace wrote: post #138
juskrey wrote: post #126

Earlier quoted context omitted.

So you WERE in the high risk group after all, you can't advice anyone out of the risk group to start using unnecessary medical procedures.

"Don't take medical advice from strangers on the Internet." is an important rule, but "Get a yearly physical." is hardly controversial or high-risk advice, eh what?

It's not controversial, but not many people receive blood tranfusions with hep c in them.

For that reason, when I originally read his post, I thought that he contracted it just by walking down the street, seriously

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#157

Post by vilhelm_s »

tyingq wrote: post #81
losvedir wrote: post #74

Earlier quoted context omitted.

> No, they acquired Pharmasset, the company that made the cure, for $11.2B. That was a pretty low-risk move. It was already an obvious money maker. Before I was a software developer I was in equity research, and one of the companies that we covered was Pharmasset. The whole point of these research companies is to find a winner and be acquired. I get that it's low risk for the acquirer, but without that big payout the…

I pointed it out because it brings some clarity to what the R&D actual costs are, and thus some clarity to whether gouging is happening.

Isn't this evidence in the other direction: if the drug already existed and was acquired for $11 billion, then that suggests that they expect the profit to be about $11 billion. Otherwise, wouldn't they bid up the price more?

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#158

Post by tyingq »

vilhelm_s wrote: post #157
tyingq wrote: post #81

Earlier quoted context omitted.

I pointed it out because it brings some clarity to what the R&D actual costs are, and thus some clarity to whether gouging is happening.

Isn't this evidence in the other direction: if the drug already existed and was acquired for $11 billion, then that suggests that they expect the profit to be about $11 billion. Otherwise, wouldn't they bid up the price more?

In the 18 months following Sovaldi’s approval, Medicare alone spent $8.2 billion on the drug.

I know that's revenue and not profit, but that doesn't even include private insurance, self pay, or sales outside the US.

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#159

Post by jki275 »

amelius wrote: post #114
hep_c_throwaway wrote: post #62

Using a throwaway for obvious reasons. Like many of you, I'm a young and healthy guy. I haven't taken a sick day in years. Since I'm young and healthy, I didn't see the need to take an annual physical exam. Scheduling doctor's appointments is such a hassle. I'm sure many of you feel the same. So when I was diagnosed with Hepatitis C, it came as a complete shock to me. The shock was due to two reasons: 1. I wasn't inv…

If I tell this to my doc he'll just explain me the risks of preventive screening.

I think the risk of a blood draw has to be just about as close to zero as one can reasonably get.

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#160

Post by inasio »

gengchun88 wrote: post #133
yakz wrote: post #2

Antiviral drugs for hepatitis C are very effective, but they come at a steep cost. Just one Sovaldi pill costs $1,000. A full 12-week course of treatment with this drug costs $84,000. The price of other hepatitis C drugs is also high: Harvoni costs $94,500 for a 12-week treatment Mavyret costs $39,600 for a 12-week treatment Zepatier costs $54,600 for a 12-week treatment Technivie costs $76,653 for a 12-week treatmen…

If you are talking about a virus only affect small amount of population, I can understand this marketing strategy. But Hepatitis C. is a virus infects 143 million, which means it even with a $10k profit margin for one in ten here should be at least $1 Trillion profits. A company like BMS do expanding like $20 billion annually. For me all most like they could afford to operate like half of century for just one drug. N…

No, Gilead didn't develop Harvoni/Sovaldi/Sofosbuvir, it was originally discovered by Pharmasset, and then Gilead bought them for 11 billion [1]

[1] https://en.wikipedia.org/wiki/Sofosbuvir#History

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