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Ok, so this will be probably be long but I am really excited. There's no great point to the post except that I can't really talk to anyone in real life about this right now and I don't understand why things can't be this easy everywhere.
When I was first diagnosed with Hep C the nasty bitch nurse told me a single drink would kill me (bullshit) and that there was no cure (true).
I've had Hep C now for many years (more than 15). About 9 years ago I went to the liver clinic to begin peginterferon but every appointment was deja-vu. The doc would talk to me and maybe order some tests, they'd give me a DVD about how to inject myself, but they'd never give me an actual prescription. After about 4 of these instances I just stopped showing up.
A few years ago, my partner was lucky enough to be selected to participate in a trial of these new 'miracle drugs' we've all heard so much about. He was inconsistent with forgetting doses and so on, and they threatened to kick him off the trial more than once. Despite his erratic dosing, the treatment worked. Now we had a backpack full of spare 'miracle drugs' that had not been approved for use yet. Even if they were approved, the chances our Govt would subsidise it weren't great, according to the liver clinic. They were so excited about these drugs and still are, as you will see.
My plan was to use the leftover research drugs to cure myself. The drugs you get are different dependent on the strain of HepC you have and how much damage your liver has sustained. We had the same strain but I didn't know what shape my liver was in. The drugs sat in the bag and I kept meaning to start but I am a slack fuck and after a few months I became concerned that they might have expired or something and basically talked myself out of it. I threw the bag away a few months ago and now I realise that was kind of like throwing away a bag of cash but ah well, you live and learn.
Our Government hemmed and hawed but eventually the new treatments were approved and subsidised. You don't need to be dying or cirrhotic to qualify - you just need to test positive for Hep C. So, with new hope I went off to my doc for a referral. He said the new treatment was super popular and I'd be waiting awhile. That was true. I waited about 8 months before the liver clinic called me back. They did blood tests, ultrasound and fibroscan to check the genotype and see what condition my liver was in. Then they booked the follow up, which brings us to yesterday.
I was expecting more tests and more delays before getting near these drugs. Doc tells me my genotype, that my numbers are good and that my liver has no significant damage or scarring. That shocked me a bit after all these years of abusing it. It also amused me that something in my guts looks like a smiley face potato gem on ultrasound. The lady doing the tests was so visibly excited about giving this treatment. She kept saying that it would change Hepatology forever, bring down the need for transplants etc. It was really cool to see the genuine joy this discovery had brought to the staff at the liver clinic. I told the doc I had expected bad news about the state of my liver.
"I can give you some bad news if you want?"
"If you don't need to, I can live without that".
"Ok, well now I just need to call the Government."
All the paperwork and housekeeping done, Doc held out his hand and said, "Right, that'll be $70,000." I giggled and he giggled with only slightly less enthusiasm. I think he's used that line a few times before. Off to the hospital pharmacy.
Pharmacist takes my scripts and does pharmacist things while asking pharmacist questions for about 10min. He tells me it'll take about 20mins to process so I go for a walk. While walking, I realised that I only had $7. That's enough for one subsidised prescription but I was on two drugs. Shit. Here I am about to pick up tens of thousands of dollars worth of life-saving help and I can't even find seven lousy fucking dollars. Typical shitty me.
So, when my number was called and the next pharmacist starts her counselling spiel about how to take the medicine, I interrupt her with, "Um, before we get too excited," and explain my stupid seven dollar dilemma, asking if I can come pick the medication up the next day. "Oh no," says lady pharmacist. "We don't money getting in the way of anyone receiving this treatment. You are starting today and you have a month to pay. Just pay it when you pick up next month's supply." I think I can find $13.80 in a month.
So now I am sitting here with a box of Sovaldi, a box of Daklinza and a real hope of being free of Hep C within 3 months. Including medications, tests, consults and everything else, all I need to contribute to this treatment is a $50 note, and I'll get a little change.
I can understand why every not every country is in a position to cover this treatment. However, when I went to the internet to read about other people's experiences, I found people from first world countries jumping for joy that it 'only' cost them $7000. I could not access it at that cost. It baffles me that they aren't treating this like a vaccine, given the potential it has to dramatically lower infection rates worldwide - even including those people who get treated and contract it again. I realise people reading this may not be able to afford it. I really hope that changes and changes soon. Any Aussies reading this who may not know about this treatment or might be lazy - get your referral. Just do it.
Just took my first doses. Wish me luck!
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Golden goose

When the National Health Service (NHS) finally approved a life-saving hepatitis C treatment, it only allowed the most sick patients. Everyone else must accept older, less effective therapies.
Things like this will never happen in the United States, and there is no street riot anyway. Regardless of the cost, it may be a disgust for Americans to reject the immediate gold standard for a fully insured patient, the idea of ​​top treatment. Indeed, 20 years ago, this mentality played a key role in disrupting managed care.
Despite the firm support of the company and the political elite, once the news leaked, patients with low chances of getting sick and low survival chances were not treated well, and the upper limit medical insurance plan could not be spared.
However, our dislike of collectivism is only one of the reasons for confusion. These facts prove that it is difficult for the United States to control the high cost of brand medicine. cheap golden goose
Why is it difficult for the United States to suppress the price of uncontrolled drugs?
US drug pricing
In 2014, when Gilead tried to launch Sovaldi and Harvoni in the UK, the NHS worried that it could not budget for an expensive drug, delaying the time to bring them to market.
When the National Health Service (NHS) finally approved a life-saving hepatitis C treatment, it only allowed the most sick patients. Everyone else must accept older, less effective therapies.
Things like this will never happen in the United States, and there is no street riot anyway. Regardless of the cost, it may be a disgust for Americans to reject the immediate gold standard for a fully insured patient, the idea of ​​top treatment. Indeed, 20 years ago, this mentality played a key role in disrupting managed care.
Despite the firm support of the company and the political elite, once the news leaked, patients with low chances of getting sick and low survival chances were not treated well, and the upper limit medical insurance plan could not be spared.
However, our dislike of collectivism is only one of the reasons for confusion. These facts prove that it is difficult for the United States to control the high cost of brand medicine.
unpalatable
A large part of the problem is that high-priced US medicines are key to the existing international pharmaceutical market. Few people will appear in public, but the fact is that in the United States, the laissez-faire price structure has subsidized the ability of multinational drug manufacturers to comply with price controls in other countries.
When President Trump complained about the global “freelancers” in the drug trade, he was not totally unreasonable.
A recent white paper more subtly points this out: “The pharmaceutical industry is a truly international industry, with its drug development, production and distribution across national borders… Manufacturing companies need to earn enough money (the focus is to add up) To pay for the initial cost. Research costs… but [this] causes manufacturers to price discrimination between various markets and may cause certain markets to subsidize other markets.
From a global perspective, this may not sound like a bad idea. After all, the United States is the richest country in the world. Why should Uncle Sam not bear more of the burden of medicines?
Robert M Ehrlich, owner of DTC Perspectives, a marketing and consulting firm based in Atlanta, Georgia, said: “This is not a delicious argument.”
“People in the government and business circles understand this, but it is difficult to explain to voters.”
Drug manufacturers have launched ambitious public relations campaigns to highlight many of the industry’s life-saving innovations, but to no avail. “American consumers say, ‘This is great, but I don’t want to pay more than the French, German or Canadian,” Ehrlich explained.
The importance of the US market is also why Ehrlich and many others in the business/marketing of the industry have little reason to believe that importing cheap drugs from Canada or other countries to the United States will reduce costs.
Pharmaceutical companies can simply stop or reduce the number of products shipped to these countries. Ehrlich said: “Pharmaceutical manufacturers will not allow Canada’s final market to destroy their Golden Goose US market.”
Biosimilar failure
Another stumbling block is our over-reliance on market-based solutions to solve this problem, namely generics. Generics seem to be a good idea because they have been so successful to us in the past:
In response to rising drug prices in the 1970s and 1980s, Congress passed a law in 1984 called the Hatch-Waxman Act, which relieves the regulatory burden of approved generic versions.
It has achieved great success, paving the way for thousands of small molecule generics markets. The general price here is usually reduced by as much as 80-90%. (There is little mention in the drug pricing debate: the US sells more generic drugs at a cheaper price than any other country in the world, and 90% of all drugs sold in the US are generics.)
Ten years ago, when the Affordable Care Act (the Obamacare Reform Act) became law, Congress passed the Bicide Price Competition and Innovation (BPCI) Act, hoping it would be like Hatch-Waxman in small molecule drugs. It works on biological agents as it does.
Unfortunately, this did not happen. To date, only 18 biosimilar products have been approved in the United States, and only a very small number of products are available for sale. Moreover, their prices tend to be close to their competitors.
Biologics are currently a hot area, the fertile ground for the most innovative and life-saving products, and the root cause of rising consumer prices.
Ed Haislmaier, a senior researcher at the Washington Think Tank Heritage Foundation, says it’s not clear why competition continues to thrive, but at least in part because biosimilars are harder to replicate than small molecule drugs. .
He said: “[BPCI] was added after the “Affordable Care Act.”” “The idea at the time was that we had solved the problem of biosimilars, and we only said nine years later, no, we didn’t. Therefore, this is still an important issue.”
bargain
Another market-friendly idea that is widely supported in patient rights organizations is that Medicare can negotiate with drug manufacturers. According to current conditions, Medicare is a government program that provides health care to approximately 60 million seniors and must undoubtedly pay the manufacturer’s fees for their products.
Effortlessly can attract these 60 million consumers. In a free and open market, what is more practical and even more like the United States at a mutually agreed common price?
Unfortunately, this approach is also difficult when scrutinizing. In order to negotiate effectively, Medicare will need to keep the choice to leave the table. In other words, refuse to enter the market. Haislmaier explained: “You will have to take the elderly as hostages.”
Anyone familiar with American politics knows that senior citizens are one of our most powerful and worrying constituencies. Many people think that it is difficult for politicians to bargain and make these voters satisfied.
Hard to explain
Politically, lowering drug prices, or at least it seems, has been the front line of federal government goals for the past two years. When the Trump administration’s efforts to abolish and replace Obama’s health care reform lost momentum, it turned to lowering the cost of drugs.
Although medicines account for only 10-15% of national health care spending, the demand for pharmaceutical manufacturers has largely become a public image of health care reform.
However, due to the lack of similar price control measures in other developed countries, it is not clear what works. Erich commented: “The problems we have encountered in the United States are difficult to explain and may not be resolved.”
He expressed the hope that the threat of government action can convince pharmaceutical manufacturers to adjust their prices. If things continue, and a left-wing candidate like Elizabeth Warren or Bernie Sanders is elected president, then the price cap will lead to unemployment and a reduction in innovation in the sector. He predicts: “I really didn’t see a good one. The choice. The result is here.”
Another question: How serious is Trump to face this problem? His government has come up with some ideas for cost reduction, the most recent of which is a pilot program to import drugs from Canada.
However, every step towards regulation requires another step. For example, Trump gave up the plan to make tax rebates illegal, prohibiting the shortening of drug patents in the new North American Free Trade Agreement, and trying to weaken a 1980 law, Bayh-Dole, which could be used to contain ” Unreasonable “drug prices.
At the same time, as the federal government faltered, states continued to pass their own laws on the issue. Trish Riley, executive director of the National Institute of Health Policy, said: “It is safe to say that every state is trying to solve this drug problem.”
Riley admits that plans to import drugs from Canada or other countries may not work, but he believes these concerns are not important. She said: “What’s important is that this is a new field.” “There are only a few tools in the state’s toolbox, and that’s one of them.”
She said that if, in addition to forcing Congress to take action, any other reason forced the states to intervene: “In the states, we make every effort. We can make corrections in the middle and do our best. Some things work well, others don’t work. But All of this illustrates the importance of federal reform.”
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