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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

#231

Post by refurb »

heisenzombie wrote: post #211
vilhelm_s wrote: post #144

Earlier quoted context omitted.

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’m not sure that assertion is borne out by the data: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866602/ I think two big missing factors in your analysis are (1) profit — US drug companies pocketed something around $30 billion dollars this year, and (2) inefficiency - something like $20 billion dollars went into deg marketing in the US for example, which seems to me like almost a complete waste.

Just measuring profit ignores all the companies who went under because their drug didn’t work. You’re just counting the winners.

And marketing includes things like paying a sales rep to answer doctors questions. Are you saying they shouldn’t do that.

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

#232

Post by 3fe9a03ccd14ca5 »

burfog wrote: post #226
oleg_k wrote: post #140

I’m working on direct-to-consumer STD testing in JasonHealth.com . Some thoughts on Hep C testing: Hep C Antibody is a very inexpensive test. We charge $25 for it. It takes a long time for the body to produce the antibodies after infection. This test is only 90% sensitive after 12 weeks ( https://www.hepatitisc.uw.edu/go/screening-diagnosis/acute-d... ). Testing shortly after possible infection with this test is not…

That is obviously not "full STD screening". Missing: human papilloma virus (HPV), mycoplasma genitalium, trichomoniasis, chancroid (haemophilus ducreyi), Lymphogranuloma venereum (LGV), Methicillin-resistant Staphylococcus aureus (MRSA), molluscum contagiosum, scabies, crabs

MRSA is an STD?

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

#233

Post by klyrs »

barry-cotter wrote: post #187
zeta0134 wrote: post #123

Earlier quoted context omitted.

I'm not sure about the general population, but this seems to be quite common in the homosexual population, especially among males. The big risk there continues to be HIV, but if you're going to get screened regularly anyway, might as well check for everything else. (Source: I am a homosexual male.) I'm not sure there should be all that much stigma attached to it honestly. There are enough non-STI ways to contract som…

> There are enough non-STI ways to contract some of these diseases that I think it makes sense for even married, faithful, and generally low risk partners to get a round of testing every once in a while. Really? Chlamydia, gonorrhea, syphilis? How can you get those without having sex?

Bad news on chlamydia: it can infect the eye and spread through personal contact.

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

#234

Post by refurb »

clavalle wrote: post #222
masonic wrote: post #210

Earlier quoted context omitted.

It's a pricing model in line with extortion This common attitude is why I fear that we won't see true cures for anything, except perhaps from government labs. This class of HepC drugs (Solvaldi et al) are cures . Not chronic treatments , but cures. The developer only has that one course of treatment to make all the revenue they ever will on that patient. So what happens when they are told that they can't charge price…

If everyone in the United States with Hepatitis C was treated at a cost of $50K it would be $150 billion dollars. That's over 8 times what Viagra pulled in over the past 20 years. I'm not sure where the line between reasonable profit-taking and extortion lies, but it's probably somewhere south of the GDP of Kuwait.

$150B would be the same as the lifetime sales of Lipitor, which was not even a cure.[1]

[1] https://www.kiplinger.com/slideshow/investing/T027-S001-the-...

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

#235

Post by klyrs »

masonic wrote: post #218
inasio wrote: post #199

Earlier quoted context omitted.

The two key groups in western countries are baby-boomers (likely acquired the infection from dentists/doctors reusing needles), and intravenous drug users. The best bang for your buck is in testing and treating this last population, but you have to be careful and try to do followups to prevent reinfection. It's worthwhile to test the baby boomer population as many of them could require liver transplants soon if not d…

(likely acquired the infection from dentists / doctors reusing needles) In Western countries?!

My aunt is such a boomer. She got hvc in the military from a pneumatic vaccine injector. The DoD apparently discontinued this practice in the late 90s.

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

#236

Post by giarc »

3fe9a03ccd14ca5 wrote: post #232
burfog wrote: post #226

Earlier quoted context omitted.

That is obviously not "full STD screening". Missing: human papilloma virus (HPV), mycoplasma genitalium, trichomoniasis, chancroid (haemophilus ducreyi), Lymphogranuloma venereum (LGV), Methicillin-resistant Staphylococcus aureus (MRSA), molluscum contagiosum, scabies, crabs

MRSA is an STD?

I also wouldn't call scabies an STD. Just as likely to pick up scabies shaking someone's hands then someones........

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

#237

Post by giarc »

wtdo wrote: post #189
3fe9a03ccd14ca5 wrote: post #91

Earlier quoted context omitted.

It’s basically to the point where it’s: > Go to and be treated for

As an American, how does that work in practice? I know I can go to Vietnam and be treated for a small amount (I was in a Vietnamese hospital for a couple of days due to a really bad strep infection and dehydration as I was unable/unwilling to swallow, and in a separate incident, also had a round of rabies shots after being bitten by a dog there). I figured it was cheap because everything is cheap there and no one the…

I work in a Canadian hospital. We have OOC patients all the time...Out of Country. During their stay, they or their family get told to visit the business office to set up payment. The business office is a tiny, one person desk in the hospital. They will take payment directly or will correspond with your insurance provider. This is mostly for people with emergency and unplanned admissions. I'm not sure how it would work for elective procedures or med purchasing. You could probably walk into a walk in clinic and pay out of pocket as almost all with have debit/credit machines since some things aren't covered in Canada (travel vaccines for example).

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

#238

Post by refurb »

inasio wrote: post #152
trimbo wrote: post #15

Earlier quoted context omitted.

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…

The adverse effects for interferon were brutal. It has a boxed warning about suicide.

I’ve talked to people who took it and it was like having the flu for months.

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

#239

Post by refurb »

3fe9a03ccd14ca5 wrote: post #91
coder1001 wrote: post #20

Earlier quoted context omitted.

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

It’s basically to the point where it’s: > Go to and be treated for

Actually, the cost of HCV drugs is less in the US than in many EU countries due to the aggressive competition.

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

#240

Post by somewhereoutth »

DoofusOfDeath wrote: post #192
jxramos wrote: post #163

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 doe…

This seems related to the political question of how much healthcare costs should be socialized, i.e. spread across a group rather than shouldered by individuals. As someone who doesn't smoke, barely drinks alcohol, doesn't take illegal drugs, and (I hope) is in a lifelong-monogamous relationship, I hate having to cover healthcare costs specific to those problems. On the other hand, as someone with chronic mild obesit…

On the subject of shared costs/benefits: The wealth that allows us modern healthcare is not so much the wealth we are producing today, but overwhelmingly more the wealth that the countless generations before us have created. That one person should benefit disproportionately from this wealth, just because by some narrow financial measure their small contribution is slightly less small than another's, is surely against natural justice. Healthcare is our birthright, part of the Universal Basic Stake that we each inherit simply by being born.
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