Hello,

This patient has high fibrosis and definite cirrhosis so would benefit from more than 12 weeks treatment – 24 is ideal. If treatment length is 12 weeks then using Ribavirin should be viewed as important.

4 week result is ok. Undetected would be better but <12 is undetected for test that does <25

Low platelets are expected. Other results are within expectations.

We do see some degree of fatigue in some patients on treatment. Vitamin B12 and Vitamin D seem to have helped some people.

Blood pressure is nothing to worry about.

Water, food, and exercise sound fine.

7.4 is less than 10.5 and this is one of those cases where less is more!

There was a 12.1 to 4.5 from one of my patients recently posted on Facebook.

It’s great to see stuff like this happening.

Hopefully your global wellbeing is also up – that’s really the point, rather than the numbers.

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, 07:5

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.

I wish I could keep my outlook as positive as your Woobia22!

My opinion – this is what happens when a lifesaving drug is priced out of reach for the majority of patients who could benefit from it.

I wish it was true!

To my thinking the heart of the matter is that Big Pharma has been strangling the geese that lay the golden eggs for years, rather than carefully nurturing them.

Actually a better analogy is “over grazing” or “over fishing” – as a profit strategy it works for a while but the incessant price hikes of both new and old medications have effectively tapped out the available pool of insurance and government dollars. This has almost certainly been going on forever but the pace has recently ramped up rapidly, so rapidly that we (as in patients and legislators) have noticed.

It’s a bit like boiling a frog – if you put it in cold water and steadily increase the heat it won’t jump out and will eventually get cooked, but if you try to drop it into boiling water it will jump straight out. The slow and steady price hikes of years gone by went by the wayside, but recent events have been so egregious that people are starting to notice. Patients are wanting drugs that legislators don’t have the cash to fund.

No drugs are 100% safe. Even water (in overdose) is fatal.

When looking at new, not 100% safe medications, the quantity of risk that is “allowable” depends on disease being treated.

It is a risk benefit analysis with a heavy bias to the benefit side.

With cancer drugs, they are pretty poisonous BUT they are treating a generally fatal illness so that’s accepted, although of course some patients do that analysis for themselves and decide that the benefits are not worth it.

With headache tablets, they need to be really, really safe because they are treating something non life threatening…..

Hep C is dangerous.

The old drugs were definitively more toxic than the new drugs and we observed that many patients voted with their feet and declined them.

The new drugs are much better in terms of both safety and efficacy (working-ness) and we’ve seen a large group of people take them (about 2 million) with the vast majority getting cure. Unfortunately a small minority have problems.

Getting out of bed is dangerous. Staying in bed is dangerous. Breakfast dangerous, but starvation is fatal.

Life is a terminal disease, and sexually transmitted at that.

Hello t3man,

While it’s entirely possible that you are suffering residual side effects people forget that for a group typically in their 40s 50s 60s there are lots of other medical things that happen.

What I would suggest is seeing a doctor and NOT telling them about your HepC and Treatment so as to force them to consider other causes, just like they would for any other patient arriving with the same symptoms.

At 6 months the drugs are totally out of your system, as in down to the last molecule gone.

Pretty much every enzyme system, blood cell, and lots of other cells has been totally replaced by newly manufactured versions, so there are a very limited number of ways that something caused by the medications could continue. That’s not zero ways, but it is a very limited number of ways.

As well as routine bloods like FBC, LFTs, Cr U&E you want things like TFTs, BSL, RhF, ANA, ESR, B12, VitD, Iron Studies to rule out lots of the common suspects.