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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

#161

Post by inasio »

idclip wrote: post #3
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…

Jesus how much did these drugs cost to develop? Are these numbers justified?

It cost exactly 11 billion for Gilead to "develop" Sofosbuvir

(they bought Pharmasset who discovered the drug [1])

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

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

#162

Post by DrAwdeOccarim »

LinuxBender wrote: post #80

This is likely going to be an unpopular question and maybe I m just really naive, but is the protein really so complex to synthesize that a kit could not be made to make a small batch at home? I ask this because I have recently been studying what is required to produce non naturally occurring amino acids and while not trivial, it can be done. Are there not biohackers that figure these things out as a hobby? I know, t…

That's a great question. In this case, the drugs are small-molecules (https://en.wikipedia.org/wiki/Ledipasvir/sofosbuvir) and they're complicated ones at that. So trying to make that at home would be impractical.

But you're on to something I've been personally interested in for a while. You can make proteins at home in cells, but to get them pure enough for injection is near impossible without expensive manufacturing equipment and testing equipment. I think the real win is going to be using mRNA coding for the protein of interest formulated in lipid nanoparticles. This type of idea would be easier to make sterile and have basically no risk of endotoxin/virus issues recombinant proteins have. I give it 10 years before garage biohackers start really getting this idea to work.

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

#163

Post by jxramos »

Here's the crux point...

""" ...clinicians are now able to successfully cure at least 95% of patients with the chronic condition with oral medications that have little or no side effects.

"With such an effective means for cure, it only makes sense to universally screen patients," Cheung said. "Implementation of universal screening will also decrease the likelihood of primary care physicians forgetting who does or does not need screening -- and it avoids the sometimes uncomfortable discussion with the patient about why they have been labeled as high risk and needing further screening." """

I think the fact that high risk populations rock the medical boat so globally already makes medicine awkward regardless of avoiding uncomfortable discussions. All these blanket treatments and tests just paper over the fact that there are wide impacting subpopulations with poor health in our populous driving the need for these things in the first place. It's the next immediate question that gets raised when you evaluate 'why do I need another HIV test' or whatever other blood test it is that medicine pushes on you. Eventually it dawned on me that these blind blanket decisions are simply because these doctors don't know anything about a patient's personal life and what risky subpopulations they may or may not belong to. But from the patient who knows what virtue they live or don't live some of these tests just come off as absurd knowing your own life history and the absolute absence of risks you deliberately avoid in life. One step of indirection is not much to jump over for one who naturally asks the next immediate question.

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

#164

Post by landryraccoon »

juskrey wrote: post #126
hep_c_throwaway wrote: post #122

Earlier quoted context omitted.

Yes, I got it from a blood transfusion when I was a child. The Hepatitis C virus wasn't identified until 1989, and blood bank wasn't wide spread until early 1990s, so anyone who received a blood transfusion before then is at risk.

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.

I suspect that unless you are a medical doctor or researcher on the cutting edge reading this you have no idea if you are in a high risk group for a disease.

The field of medicine is advancing so quickly that most people’s “common sense intuition” about what is high risk and what isn’t is likely to be very misleading.

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

#165

Post by MisterTea »

hep_c_throwaway wrote: post #122
crobertsbmw wrote: post #104

Earlier quoted context omitted.

Did you ever figure out why you got HepC? Did you conclude that you had it from birth, or did you remember that you stepped on a nail while traveling in Vietnam?

Yes, I got it from a blood transfusion when I was a child. The Hepatitis C virus wasn't identified until 1989, and blood bank wasn't wide spread until early 1990s, so anyone who received a blood transfusion before then is at risk.

> I only caught my Hepatitis C because I wanted to an elective cosmetic medical procedure. It was my own vanity, plus pure luck, that caught it.

This wording is a little ambiguous because "catch" can mean both diagnoses and the point of infection. So I read that as you were infected by hep c during a cosmetic medical procedure.

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

#166

Post by Consultant32452 »

jki275 wrote: post #159
amelius wrote: post #114

Earlier quoted context omitted.

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.

It's not the blood draw, it's false positives resulting in unnecessary expensive and frequently invasive procedures done. A quick Google search for too much screening provides many results on the topic.

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

#167

Post by MisterTea »

vilhelm_s wrote: post #144
phkahler wrote: post #129

Earlier quoted context omitted.

>> They're priced this way because they're 80-90% cheaper than the previous treatment. Your statement is true. But it also hints at another problem, which is that the default is to price life saving treatments as high as the market will bear. It's a pricing model in line with extortion, the only exception being that the extortionist doesnt have to threaten to kill you - the virus or whatever condition is already maki…

I think it's the "right" price, you want to incentivize companies to try to develop drugs that will do the maximal amount of good. Like, you could imagine a system where you don't have a free market at all, the government would directly fund both medical treatment (like in Europe) and medical research (like nowhere right now, but you could imagine nationalizing the drug companies). So then, before the hepatitis-c dru…

> I think it's the "right" price, you want to incentivize companies to try to develop drugs that will do the maximal amount of good.

So the only incentive to do maximal good is more money. And people wonder why I laugh when it's claimed that we live in a civilized society.

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

#168

Post by nkozyra »

anonuser123456 wrote: post #108
nkozyra wrote: post #58

Earlier quoted context omitted.

> The free market economy doesn’t work in this case. While I think this is self evident, it depends on your definition of "working." If we - a I personally think we should - attach a social caveat to capitalism that requires we do what we can for people less fortunate, it fails miserably because we lack a mechanism for fostering unfettered profit while ensuring healthcare is available to all in a reasonable form. No…

>If we - a I personally think we should - attach a social caveat to capitalism that requires we do what we can for people less fortunate, it fails miserably because we lack a mechanism for fostering unfettered profit In the case of intellectual property/technology you are mistaken. Patents have an expiration. Capitalists are provided a time limited monopoly for the sake of extracting rent in exchange for development…

You're operating on a false dichotomy, though. Why is this the only environment you can envision wherein drugs can be developed?

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

#169

Post by hep_c_throwaway »

nabnob wrote: post #115
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…

Do you have any theory about how you caught hep-c? What's your experience with treatment? Did your insurance cover it?

I got it from a blood transfusion when I was a child.

I got diagnosed back in 2016, and the available treatments back then wasn't great. As an alternative, my doctor signed me up for the clinical trials for the drug now known as Harvoni. I figured that it's a moonshot and didn't pay it any mind. (Having read Stephen King's Firestarter didn't help either.) I also moved to a different city for a job. Months later the drug company called and told me I qualified. The drug trial would have been free and would have cured my hep C, but alas I can't afford to quit my job and fly back to the old city for 3 months. (In hindsight I probably should have.)

Around 2018 when generic Harvoni became available from Indian manufacturers, I got serious about curing my hep C once and for all. I found a doctor that's willing to work with foreign-sourced Harvoni and ordered it online for $1300 (all out of pocket). I started the treatment under my doctor's directions and it went smoothly.

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

#170

Post by jp57 »

The article says nothing about the false positive and false negative rates of the test, and proceeds as if the screening is infallible.

Even given what was said in the article, one has to assume that the incidence of the infection in the general population is quite low—probably measured in basis points—which means that the false positive rate of the test would have to be very low to get a high positive predictive value. It may well be so, but we'd need to know that (and the costs of treating the uninfected) to understand whether universal testing is really warranted

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