Hep C: There’s a cure, if you can afford it

This is one of those “good news-bad news” stories. We seldom get to witness an actual cure to a disease, but that is exactly what’s happening with Hepatitis C.

First, a very short Hepatitis C 101: “Hep C” is an ongoing challenge in our communities. It is transmitted through blood. It can be transmitted through needle sharing, sharing toothbrushes or razors, tattoos (including the ink), body piercing, through open cuts or sexual transmission where blood is present (menstrual blood, vaginal or anal abrasions). It is far more prevalent than HIV, is much more easily transmitted and is seen in a wide range of populations.
Many baby-boomers are infected with Hep C. Individuals who worked in jobs or served in the military where they were exposed to blood through open cuts were often exposed to Hepatitis C. They in turn, often unknowingly, infected their wives/husbands/partners.

Folks who inject drugs and share needles are also at high risk for Hep C. The blood can be in the syringe and thus injected with the drug into the next user.

Then, of course, there is the phenomenon of tattooing and body piercing that has become a common practice for people of all ages. When tattoos and piercings are done correctly in a sanitary setting, they are perfectly safe. It’s the ones done at home in someone’s basement by their uncle’s best friend or the shop that doesn’t take proper precautions that have the potential to carry Hep C. They often use the same needles and the same ink over and over, or don’t properly clean their equipment.

One of the big differences between HIV and Hep C is that the Hep C virus (HCV) lives much longer outside the body. A study at Yale University published in 2013 showed that HCV can live on a surface for up to 2 weeks and in a syringe for up to 63 days. While the virus may lose some of it virulence, it is still considered to be infectious.

So, for the reasons stated above, it’s rather clear why there are so many people living with Hepatitis C. If left untreated, Hep C often leads to liver disease including liver cancer and other liver-related problems, which may lead to death. We know that many people living with HIV are co-infected with Hepatitis C, which can complicate both conditions. It is extremely important that persons living with HIV are tested for Hep C.

For years the outcry from folks in the healthcare and prevention world has been that while we can test individuals for Hep C, many had no access to treatment. There have been virtually no programs to help pay for treatment and nowhere to send clients for assistance.

Until recently, the most common treatment for Hep C was interferon. I’ve heard many Hep C clients compare their treatment to chemotherapy. The side effects were nearly intolerable and the outcome was often disappointing. Many people were weakened by the treatment and died.

BUT then, a HUGE change! A couple of years ago we began hearing about the progress in the treatment of Hep C – not just a treatment, but an actual cure!
Last spring, I attended a conference where the instructor, a local physician, used the word “cure.” Just a few days ago, one of our staff members asked a healthcare provider, “is this truly a cure?” and the answer was YES. Most studies have shown a high success rate between 85 and 100 percent.

This is outstanding news, and of course we are very excited. The problem is the cost. The new course of treatment is about 12 weeks, but can be as little as eight or as many as 20. The average cost for that treatment is approximately $80,000 to $100,000. There are some medications coming on the market that claim to be about half the cost, but is even $50,000 realistic for most people? Many insurance companies are refusing to cover these drugs because of the cost. Most drug companies have patient assistance programs for folks who cannot afford their medication, but those programs are very limited and don’t come close to covering the number of people who need help. Hopefully, over time the cost will come down considerably, but for now, many people are left out of the opportunity for a cure.

None of this is to suggest that the pharmaceutical companies are the bad guys. I understand that research is extremely costly and it often takes years to bring a drug to market.

I am thrilled with the fact that people with HIV are living longer, healthier lives because of the ongoing progress of HIV medication. And, here we are with an actual cure for Hepatitis C.

But, it is still difficult for me to accept that $1,200 a pill is reasonable. I have no idea how much profit is in that one pill, but if I had to take one pill once a day for 12 weeks, that is $100,800. So, the good news is, there is a cure for Hepatitis C. The bad news is, it’s going to cost you $100,000.


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