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Hepatitis C kills more Americans than all other infectious diseases combined

scopeblog.stanford.edu

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

#121

Post by Retric »

lotsofpulp wrote: post #47
Retric wrote: post #39

Earlier quoted context omitted.

Insurance increases net costs via added overhead. So, it’s ~80k * ~1.30 * (number receiving treatment) / (people paying insurance). Aka, it’s both more expensive and more affordable.

Health insurance in the US has overhead capped at a maximum of 20%, or 15% in large employer groups. https://www.healthcare.gov/health-care-law-protections/rate-...

Spending 80% of your premium on direct heathcare cost means ( 1 / .8 - 1) = 25% cost increase, but that’s on top of the heathcare providers insurance related overhead. Insurance only adding 30% to total heathcare costs is a reasonable ballpark though likely an underestimation.

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

#122

Post by hep_c_throwaway »

crobertsbmw wrote: post #104
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…

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.

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

#123

Post by zeta0134 »

astura wrote: post #85
ssorallen wrote: post #76

Earlier quoted context omitted.

I didn’t read this as advocating for everyone to run to get tested immediately. This is more a call to healthcare professionals to advocate for this testing. One way this can roll out is when sexually active adults who are considered low risk for HepC hopefully do their regular STI screening, either they or their healthcare provider can request a HepC test.

Are "regular STI screenings" common in the general population (not sex workers) in absence of symptoms?

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 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.

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

#124

Post by Retric »

lotsofpulp wrote: post #105
phonon wrote: post #90

Earlier quoted context omitted.

What percentage of the recepients costs are insurance related overhead as well? (Yes, that includes the time doctors spend arguing with insurers).

Surely, there is room for optimization, but in the alternative case of taxpayer funded healthcare, I'm sure the government is going to ask doctors for justifications for the same reasons insurers do. Someone needs to provide a second opinion on whether or not procedures and medications are appropriate for accountability purposes.

Governments add far less overhead in this area because they have more data and can thus use random inspection of bills for validation. Further, when setting rates every insurer has a separate negotiation involving even more overhead.

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

#125

Post by refurb »

crobertsbmw wrote: post #104
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…

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?

Hepatitis C is transmitted through blood and body fluids.

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

#126

Post by juskrey »

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.

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.

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

#127

Post by refurb »

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…

These are the list prices. Due to competition, net prices came down considerably as the different company try and get market share.

Current prices are closer to $30,000 or less per dosing regimen.

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

#128

Post by [deleted] »

juskrey wrote: post #116
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…

Sounds like typical advertisement of modern anxiety and fear dealers. Every medical interaction, including screening and even friendly talk with doctor, has side effects.

[deleted]

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

#129

Post by phkahler »

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…

>> 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 making the threat for them.

I was about to summarize by saying "sometimes a free market can mimick evil" but I just remembered it's not a free market at all. These treatments have government granted monopoly status via patents. That's why they are priced so high.

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

#130

Post by jokowueu »

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 go to Egypt it's much cheaper http://www.tourncure.com/en/
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