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When Are You Cured?
Excellent piece on tailoring tx times:
G 1a F-1
Started tx 10/23/15 (Meso sof & led) ALT 48 AST 28 v/l 1.6 mil
11/17/15 4 wk lab ALT 17 AST 16 <15
11/18/15 Started Harvoni
12/16/15 8 wk lab ALT: 15 AST: 13 V/l UND
1/14/16 Fin. Tx
7/07/16 UND SVR 24
Interesting report, but it is very much couched in terms of $ savings.....oh, and maybe some improved health outcomes and better treatment adherence?
It seems to me to sum up a lot that is wrong with our approach to health these days. Where is the study that says "What is the optimum treatment length by patient to minimise adverse effects and improve adherence......and maybe that will save some money too?"
As a counter foil to the assumptions made in the report, I would suggest these drugs don't have a particularly high cost but they do have an obscenely high price.
G3a since '78 - Dx '12 - F4 (2xHCC)
24wk Tx - PEG/Riba/Dac 2013 relapsed
24wk Tx - Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx - 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 - 22/06/17 UND
SRV12 - 27/07/17 UND
SVR24 - 26/10/17 UND
Yeah, absolutely agree. As usual, this kind of calculation starts with the implicit assumption that the cost of treatment is a "given" and then goes on to analyse the complex medical question of whether and how a certain treatment is "cost-effective".
Brilliant. I can do that kind of thing myself with absolutely no medical training. Its not that much different from working out whether it is cost-effective to take a holiday from time to time.
Why do so few medical people start from the right place before they do their complex calculation - i.e. why don't they ever ask what is the true cost of a drug treatment, and why are so many people suffering due to corporate greed and price-fixing?
And while I'm on the subject, It really pisses me off me every time I read the standard Gilead speel about how their treatment is cost-effective compared to a liver transplant...
What about the human and job-productivity cost of waiting all those years until you get to the (almost dead) state of actually needing a liver transplant?
Diagnosed Jan 2015: GT3, A0+F0/F1. Fatigue + Brain-Fog.
Started Sof+Dac from fixHepC 10-Nov-2015. NO sides.
Pre-Tx: AST 82, ALT 133, Viral Load 1 900 000.
Week4: AST 47, ALT 58. VL < 15 (unquantifiable).
Week12 (EOT): AST 30, ALT 26, VL UND
Week16 (EOT+4): AST 32, ALT 28, GGT 24, VL UND
Week28 (EOT+16): AST 26, ALT 22, GGT 24, VL UND
Ever grateful to Dr James.
Relapsed somewhere after all that... Bummer!
Jan 2018: VL 63 000 (still GT3).
That article does not get into any specifics. I read that Harvoni rate of cure for 8 weeks of treatment was only 76%. Dr. Freeman posted somewhere also that the overkill factor is effective in raising SVR rates. Personally, I would not be comfortable with being tested weekly, and upon reaching undetected, cut off from treatment.
OMFG, this really reeks of desperation on the part of Gilead to justify their pricing. Because we know that you are better off with 12 weeks of treatment, this is disgusting. America has been reduced to a place that only looks out for corporate interests and things that benefit the wealthy. China and India both rejected Gilead's patent. Seems to me the people in charge of regulation in USA may have been offered lucrative jobs in the private sector for favorable decisions while in office. That is SOP in USA for many industries, from finance to energy, and possibly big pharma.
Gt 1a, F0, VL 6.5 million, AST 59, ALT 62
Started Twinvir 1/15/16
6 wk. labs VL UND, AST 27, ALT 20
EOT labs VL UND, AST 23, ALT 19
SVR 16, VL UND, AST 28, ALT 17
SVR 24 , VL UND, 10/8/16
SVR 125, VL UND, 9/22/18
SVR 230, VL UND, 10/3/20