old school

what does "old school" mean as it relates to hepatitis treatment?

[cruelworld]

how is that treatment different from today?

[avidreader]

I'm guessing when people say 'old school' they mean SOC (standard of care.) Standard of Care is the generally accepted and approved protocol for the treatment of a disease. SOC is also what the insurance companies will pay for. There are many many strong indicators that there should be changes to the SOC for Hep C, but most of them would drive up the cost of treatment so don't hold your breath. An easy example: Most people familiar with the disease, the research, and recent treatment studies would suggest that a 4 week PCR is a VERY good indicator of of the odds that treatment will work. Most Insurance companies won't approve a PCR until the 12th week of treatment. The tests are expensive. Some doctors will buck or fight the insurance companies some won't. Another example: The SOC call for a 2 log drop in the viral load by the 12 week PCR and an undetectible by the 24th week. If you don't hit these 'benchmarks' the odds for treatment success plummet and the cost/benefit ratio get's a little to high (not to speak of the toll on the body.) Most insurance companies will cut you off at this point. All of that being said, I didn't clear till 26 weeks (my doctor had to do a little date fiddling to keep the insurance folks happy) but did clear the virus (at least so far and I'm 9 months post treatment) But, I consider myself extremely lucky, and I did have a doc who bent SOC on occasion with samples. I almost gave up at 24 weeks, but I was so close to undetectible my doc convinced to keep going. Another treatment modality that has gained some credibility is that you should treat for 36 weeks after you clear the virus. For me that would have meant a total of 62 weeks. My insurance company wouldn't cover me past 52 weeks. So--in a rambling way, there is my answer and my story. Good luck to you!

[cruelworld]

so new school is esentially just earlier and more frequent pcr's for better svr prediction?

[jboyhk]

There is alsothe issue of 'rescue drugs'.

Most don't realize but these are given by dr's on an 'off label prescription'. I don't know the legality, but I assume the dr's are running potential lawsuit risk. God forbid some unforseen side effect occurs from the rescue drugs (maybe not now but in 5-10yrs time for instance) they will be put in the spotlight for prescribing drugs not approved in the way the FDA allowed it.

[pigeonca]

What's so ironic about the insurance companies disallowing PCR's at 4 weeks is that, if the patient is UND at that point, his treatment might be shortened - sometimes even halved in the number of weeks required.  12 weeks is a heck of a lot cheaper than 24, and 24 is a big heck of a lot cheaper than 48.  

[mauilady]

Since when did ANYTHING the insurance companies did make any sense?  Maybe 30-40 years ago...

[madbrad]

Just for posterities sake my tx will cost the VA around 36k dollars and that doesn't include rescue drugs nor drugs to handle the sx's.....I hand EPOetin for 6 weeks at an additional cost of 4k...And these costs don't include Labs.