Sabrecat,

I largely agree your sentiments when translated to the realities of politics and commerce but the idealist/perfectionist in me says we could do better and cheaper both for Australians and as models for the international community. Something to dream of and work towards.

Well, that is my estimate of what it will cost PBS if everybody was treated. Apparently there is a cap on what/how many the PBS scheme pays each year with the pharma companies paying for any patients that want treatment and exceed that cap. That is why my proviso that we would need to treat approx. 46,000 per year (actually a ramping qty over time) and we still pay the same if we don’t meet that target. The figures are a bit rubbery as always when dealing with these sort of things but I suspect the Pharma’s are betting on not having to treat anywhere near that number. James put together some figures based on the best knowledge available just after the initial announcement per below blog.

http://fixhepc.com/blog/item/32-pbs-listing-heaven-or-hell-the-devil-is-in-the-details.html

The other point is that proposed guidelines seem to indicate state of the art Tx for G1 & G3 but only Sof/Riba for G2 and an evil Sof/Riba/Interferon brew for G4,5,6.
My (really Jimmy’s) generics suggestion costing uses Sof/Dac or Sof/Led for all genotypes. And still much cheaper!

Hi Bloot, how ya goin?

That sounds like a great result on the fibroscan! I think there is reasonable cause for optimism that in your case the results may be fairly accurate…..but understand your caution and wish to keep to the original Tx plan.

Judging from the tale above, and some previous ones we have heard from you, you made some very significant changes to your lifestyle upon diagnosis. I imagine your liver was extremely….and eternally….grateful when you stopped beating the living crap out of it at every opportunity.
So when it suddenly didn’t have to defend itself against its owner on a daily basis, it was able to fend off the HCV a little better and at the same time it had enough reserve capacity to make use of its marvellous ability to regenerate, enough to regress the worst of what was probably largely self inflicted damage rather that from the hepatitis.

OTOH bad attitudes don’t regenerate so you are out of luck there mate.

(better point out here that I’m not having a go at Bloot, my attitude and behaviour was not too dissimilar to his. It was just a bit too late for my unfortunate liver by the time I was diagnosed. )

On the subject of fibrosis measurement accuracy, I like the summary provided by the specialist assigned for my initial consultation after diagnosis. A very funny man with a wicked sense of humour. illy:' />

– Autopsy is the gold standard…..but due to the significant risks he didn’t recommend them for most of his patients.

– Biopsies were definitive but really only for the immediate area around the sample sliver due to the size of the liver and the fact that fibrosis was not necessarily an uniform process. Safer than the first option but still some risks.

– Fibroscans were indicative but with sufficient readings across a larger area did give a pretty good idea of of the level of fibrosis although with a margin of error that was difficult to fully quantify. Much safer and these days (2012) his recommendation in most cases.

Hi Jaz,

If it’s any consolation, I am in the same situation. Waited three weeks for my results due to Xmas break then told the lab only ran qualitative on mine. So now further wait for quantitative retest results. I’m not worried about not being undetected at 4 weeks as I knew that was a long shot with my status/history but not knowing if there is any change at all is frustrating. (Though I assume there must be change as my LFTs were improved a lot and I feel heaps better )

For others, may I suggest you clarify exactly what they are testing prior to the test to avoid this situation.

Thanks Sir, I agree with your summary of Sof/Dac.

Regarding Riba, I’ve been trying to post here since dt brought it up but couldn’t find the words previously, so here goes:

This is my second round with Riba and i find it easier than when combined with Peg. But I should caution here that my response to Riba is pretty good without some of the serious sides like extreme rage and anaemia that others experience and this was one of the things that my specialist and I discussed when deciding to incorporate it in my treatment this time round. I mostly get insomnia and tears with a little tiredness from it. But I did start out with Sof/dac for two and a half weeks while waiting for the Riba to arrive so know how much easier things are without it.

My caution to anyone taking Riba is to ensure your bloods are monitored regularly, watch for any rashes or other unusual physical symptoms and most importantly be alert for any strong emotional reactions to anything. If you feel those coming on stop!, disengage!, take time out!, remind yourself you are on Riba! It also helps to have someone understanding to vent to (not at) and many of us here have prior experience of it and I am sure will be happy to help so don’t risk personal relationships or careers by being afraid to talk about how you’re feeling.

PS I’m always available for a private chat if online.

Hi Sir,

Yes, I believe that is what Jimmy is saying, generics would be cheaper and we could use the saved money elsewhere.

Based on current Indian/Pakistani generics bulk buy prices it would appear possible to treat the whole Australian HCV population of approx. 230,000 for less than half a billion A$ (including those like myself who require 24wks). Yet our government has chosen the brand name path for one billion to treat what will probably turn out to be only a small proportion of those infected.

So:

Generics
A$500,000,000/230,000 = A$2,174 or US$1,522 avg per treatment max cost if everyone wants treatment.

Or

Branded
A$1,000,000,000/230,000 = A$4,348 or US$3,440 avg per treatment assuming we can process at least 46,000 treatments per year (but we pay the full billion either way)

IMHO the first option sounds like better economics and I suspect average cost would be significantly less than the generous price I have allowed.

And a spare half a billion dollars is quite a bit of money that could be used by our medical system to treat other ailments.

Very weird, my scaly, reptilian, old man elbows are turning smooth as a baby’s bum after 8 weeks on treatment. WTF!!!

Hi 2b and Stew,

While we talk about Australians being lucky, and we are as far as Dr James, Greg and the compounding chemists go, to some extent I believe most of us have still had to make our own luck.
I know in my case, my specialist didn’t mention anything about generics until I asked……then he wrote me a script. But I suspect that if I hadn’t been pointed to Greg and Dr James by my sister reading an article in the weekend press I would have continued to be warehoused. My reading of posts around here is that very few of us have had our doctors actually recommend generic treatment and that we have needed to be proactive about discovering this option and in many cases have needed to consult with someone like GP2U to get scripts.