Here is the translation. I quite like Jörg Indermitte's not a comment...
What strikes first is the strange handwriting - the one on a drug from Bangladesh. For Svitlana, this box is very important: it contains medicines which should cure it of hepatitis C. If the fifty-year-old brought these pills from abroad, it is because in Switzerland the treatment would cost some 60 000 francs, to be paid out of his pocket. For about 1500 francs, in the Indian subcontinent.
Svitlana learned her illness four years ago. She thinks she was infected with the hepatitis C virus after doing a tattoo. "My doctor told me that there were medications, but it would only work if I had any real health problems. He said the price would go down and that we had to wait. "New treatments, which appeared in Switzerland as early as 2014, have revolutionized the fight against this potentially fatal disease. Unlike their predecessors, side effects are limited and the chances of cure after three months have increased from 60% to 90%.
The health insurance fund
But in our country, these tablets are expensive and the Federal Office of Public Health limits their reimbursement. Today, patients have access to it if they have grade 2 liver fibrosis on a scale of up to 4 or if the disease manifests itself outside the organ. This second point is interpreted. According to the Swiss hepatitis strategy network (SHS, which brings together 80 personalities from the medical community, patients, insurers and political authorities), "many health insurance companies refuse to admit frequent extrahepatic manifestations such as fatigue, joint pain, difficulties Concentration, etc. ".
The Temptation of the Internet
Svitlana, she has no physical problem. But for the last four years she has been living very badly. "The disease is at rest, but things can evolve rapidly. I have to check every six months and it puts me under stress ... With hepatitis C, we risk cancer or cirrhosis. I fear that we will end up acting too late. "Like others, she is stuck. "We do not have the money to pay for the treatment ourselves in Switzerland, regrets her husband, Andre. The situation is unfair: patients should have the opportunity to take care of themselves. "
At the end of last year, André discovered on the Internet that a Baloise had gone through India to get the precious pills. He conducted his research and found several sites making such offers. "The prices were very variable. Some asked for a payment without requiring a prescription for the shipment ... I found it shady. You never know if someone will really take care of you. "And he was right: both authorities and specialists warn against the risk of buying boxes on the Internet that do not contain the right pills.
The chain passes through Australia
Finally, the couple found a buyers' club based in Australia, the FixHepC buyers Club, which has set up a controlled purchasing system in India and Bangladesh (see opposite). The proposal seemed serious. Their interlocutors asked in particular the results of laboratory Svitlana and a prescription of a Swiss doctor. It was SHS who provided this document after analyzing the medical file. "Of course, I was worried, I was afraid the boxes would not arrive," Andre said. But the contacts I had had reassured me. SHS also told me not to go through other intermediaries. "
The sequel is in a series of documents that had to be provided, such as a photocopy of the doctor's passport that followed the Svitlana case in Bangladesh. Ordered in Australia and left Bangladesh, the drugs arrived in early January after passing through Bangkok and Leipzig. As for the end, it is not yet known. Svitlana is about to start her treatment, and will be followed by her specialist in Switzerland. "If everything goes well, I can live normally again," she said. I've read that improvements can be seen very quickly. "(TDG)
(Established: 31.01.2017, 07:58)
A step-by-step approach
"Traveling abroad to get medicines for hepatitis C always carries a risk," says Daniel Horowitz, chairman of the Swiss Hepatitis C Association. "But we tested a solution and it works."
The procedure is described on the website of the Swiss Hepatitis Strategy (SHS). With a goal: to avoid the orders of medicines coming from an unreliable source and without medical follow-up.
Patients must first try to obtain a refund in Switzerland from their health insurance. In case of failure, they can turn to foreign countries. Two pharmaceutical companies have licensed Indian firms to produce their treatments under a different name in order to market them to poorer populations. They treat all forms of hepatitis C.
The specialists advise to go to the buyers' club chosen by Svitlana, and founded more than a year ago by an Australian doctor and one of his patients. The content of medicines was checked at the beginning of collaboration with foreign suppliers. The people who use it are included in a study: the first results showed that the chances of success are the same as with the original treatments. To order, you must be followed by a specialist in Switzerland, who will be present during the treatment. An Indian prescription (or Bangladesh) is required, a telephone interview with a local doctor is planned.
In Switzerland, the importation of medicines is allowed for personal needs, usually for one month. In this case, Swissmedic accepts a treatment period of eight to twelve weeks, the length of time required to hope for cure of hepatitis C. Swissmedic also requires that the recipient be aware of the possible risks and precautions to be taken, Is initiated and monitored by an experienced physician who has provided a prescription and the drugs must come from a verifiable channel.
How to lower prices?
Svitlana is not an isolated case. The President of Swiss Hepatitis Strategy (SHS), Dr Philip Bruggmann, has followed some thirty patients who have benefited from such treatment. All have recovered, he says. But they had to pay for the drugs from their pockets. "They do it because they suffer," replies Daniel Horowitz, president of the Swiss Hepatitis Association. "It's a shame that Switzerland can not treat them."
Going through the Indian subcontinent? Jörg Indermitte, Head of the Drugs Section at the Federal Office of Public Health (FOPH), does not comment on this "individual" decision. But, he adds, "if many people order a product, it can put pharmaceutical companies under pressure and cause them to lower prices."
According to the Federal Office of Public Health (FOPH), the cost of producing these pills is about CHF 150 per therapy. The pharmaceutical companies explain the difference with the sale price in Switzerland (between 45,000 and 60,000 francs) by the financing of the research. These tariffs mean that medicines are not reimbursed to all infected persons.
By 2015 2,300 treatments have been covered by sickness funds and almost 2,000 in 2016. Jörg Indermitte points out that the conditions have eased over the last three years. "We can treat patients who really need therapy," he says.
The Confederation is continuing its negotiations to lower these tariffs. "The aim is also to offer treatment to new patient categories," says Jörg Indermitte.
In October 2016, the FOPH announced its willingness to integrate people also infected with HIV or the hepatitis B virus and injection drug users. But SHS is more pessimistic, even believing that care is in peril.