Well, you know me LG, I’m always the optimist!

I like to hope that since the EASL conference in Barcelona last month and with the Hep C Trust over there now starting to provide information on safe generic treatment, the U.K. medical establishment may become a bit more receptive to acting in the best interests of their patients rather than following the bureaucratic line.

I don’t think it hurts for UK hep C patients to ask the question of their doctors and consultants to keep the pressure on and remind them where their responsibilities should sit. If they still refuse to provide support than there are the proven alternative routes to get a prescription as you suggest.

The general recommendation is to discontinue unprescribed supplements while on treatment to avoid potential untested interactions. There are some exceptions to this where there is evidence to support supplementing:

“So if you wanted to take supplements there is evidence around:
B12
Vit D (calcitriol)
Antioxidants like ALA, S-Adenosylmethionine and Betaine because they increase glutathione and probably work to protect B12 levels and JAK-STAT mediated local Interferon production
Statins because they reduce the transporters for the virus in the blood that are essential to getting into liver cells”

http://fixhepc.com/forum/supplements/534-supplements-with-evidence.html

Congratulations Michael, great news!

2 quantitative and 4 qualitative while on DAA treatment but my understanding is that the request needs to specify certain information like who the precribing/authorising physician was rather than just the monitoring one?

With the current political situation regarding pathology tests I suspect both Path labs and Medicare will be making sure they follow the letter of the rules while also point scoring against each other where they can which may mean that patients end up on the paying end of a bill for path requests that would normally just be accepted as “close enough” and paid by Medicare. Maybe their doctor needs to dot an i or cross a t on the request? Maybe it was an error of interpretation or counting by one of the above parties?

Don’t just accept the charges, challenge them and request information on why you didn’t qualify for coverage.

Hi fretboard,

Rather than you posting links or ‘how to find’ information that could possibly be mistaken by someone as an endorsement, may I suggest that advertising that obviously upsets you and contravenes eBay rules may be more appropriately reported to eBay so they can take action.
Thanks
Gaj

I think within India there probably won’t be a great deal of change in availability short term. Indians will continue to be able to access the meds if they can afford them. Gilead will probably continue to collect licence fees rather than impose their patent rights as far as manufacturing goes. However, they may well seek to prevent the current heavy discounting that we see from the various manufacturers seeking greater market share. So the cost will become the label price less the traditional local market discount of probably up to 20%. In other words the best available minimum price for Harvoni may settle at around the $300-330 per bottle level with Sovaldi at an equivalent lower price. If this does occur then it has implications for many Indians who are at the lower end of the income scale and not able to afford the higher prices. Similarly, individual tourists are always good for the local economy and will find ways to get what they need but I think any attempts to set up group medical tours will be very quickly thwarted.

Longer term, there will be greater impact as one of the main drivers of lower prices is market size and competition. If Gilead succeeds in its main aim of preventing export (while also controlling domestic prices) then the manufacturers will have less incentive and opportunity to attempt to compete for customers. Probably the current rapid expansion of manufacturing will cease and contract. This will drive up costs and result in further price increases for the Indian domestic market which in turn limits that market even more. The end result of this process is that India falls in line with the rest of the world and Gilead ensures maximum profit for their shareholders and a self sustaining income stream into the future from the new infections that will occur due to only a small percentage of those with HCV being able to access/afford excessively expensive treatment.

While the non Indian generic pill manufacturers are doing a great job, all of them are currently situated in countries that don’t have high levels of international trade so there are very real risks to continued supply from them either through Gilead actions or just the political climate. We have already seen this occur in Australia at the end of last year when our government restricted imports from Bangladesh due to alleged terrorist risk…..whatever the reason the simple fact is they are not a significant trade partner so it’s easy to achieve with little public interest or concern.
Chinese APIs are less likely to be impacted because of their stance on patents and the huge volumes of international trade they participate in but that sets us back to last year’s situation which isn’t really sustainable for a mass market and many patients don’t/won’t have the inclination, confidence or skills to follow that path.

So the patent situation in India has a very real potential to severely impact worldwide supply of generics unless international opinion can be focussed on the situation. The best way to achieve this is advocacy at both a public and personal level. We need to make the public, medical staff and politicians worldwide aware of the availability of generics and the greed and inhumanity being perpetrated by Gilead in their quest for obscene profits.

There are some excellent thoughts and suggestions about how everyone concerned by this can start to help that process in some small way in the link below:

http://fixhepc.com/forum/experts-corner/998-you-can-make-a-difference.html#15940