Aa
$ + Rank to inject Interferon & Ribavirin pls?
Hello,
I'm an Australian in a small city in Malaysia.
The city does not have a GastroEntologist, let alone a Hepatologist.
I'm looking for input from doctors in Australia, USA and any other countries please
+ input from patients who have had to buy privately please.
I have just had real time PCR and result is 476. Normal is <43 iU/mL
The diagnosis is HCV subtype 3a
Rx: 6 months therapy recommended.
My research tells me Rx is expected to be
Interferon IFN Alpha 2a 3mlU
Ribivirin 1,000-2,000 mg/day (I weigh 70kg)
x 3 weekly
BUT I'm 8 hrs round trip and many $$$ petrol or bus fare etc from a Hepatologist in the capital city.
I'm trying to swing getting the injections done by a local doctor.
QUESTIONS: (Maybe answers by different people)
1)a) In other countries, what rank of medical personnel needs to do do the injections please?
b) Is this because of cost or another reason please?
2) Can anyone tell me the private costs of buying the above medications please?
I've come up with VERY ROUGHLY about $A/$US 3,000 (+ another $2,500 transport)
Thank you ever so people, and particularly the doctors giving themselves so much to help patients.
Bill Oliver
Australian in Malaysia
I'm an Australian in a small city in Malaysia.
The city does not have a GastroEntologist, let alone a Hepatologist.
I'm looking for input from doctors in Australia, USA and any other countries please
+ input from patients who have had to buy privately please.
I have just had real time PCR and result is 476. Normal is <43 iU/mL
The diagnosis is HCV subtype 3a
Rx: 6 months therapy recommended.
My research tells me Rx is expected to be
Interferon IFN Alpha 2a 3mlU
Ribivirin 1,000-2,000 mg/day (I weigh 70kg)
x 3 weekly
BUT I'm 8 hrs round trip and many $$$ petrol or bus fare etc from a Hepatologist in the capital city.
I'm trying to swing getting the injections done by a local doctor.
QUESTIONS: (Maybe answers by different people)
1)a) In other countries, what rank of medical personnel needs to do do the injections please?
b) Is this because of cost or another reason please?
2) Can anyone tell me the private costs of buying the above medications please?
I've come up with VERY ROUGHLY about $A/$US 3,000 (+ another $2,500 transport)
Thank you ever so people, and particularly the doctors giving themselves so much to help patients.
Bill Oliver
Australian in Malaysia
Thank you for your concern Kristina.
Yes, the Riba dose was from Wikipedia I think - weight would be the variable factor.
I was born with weak lungs and had problems from my first week of life.
I was the weak kid at school and often sat out during PE/PT/sports/etc.
HCV real time PCR = 476; normal is <43 if that means anything.
All the other nasties were 60 years before the HepC was a glint in the devil's eye :-)
(couldn't resist that; I like laughing adversity in the face!)
Hmmmm - return to Australia? Thanks for the seed thought.
You've brought up something:
I had a transfusion in Australia June 2000 - over 10 years ago.
I've also had canula and injections and minor ops by the score last few years in Malaysia. The Malaysian hospitals are trying to blame the transfusion 10 years ago.
I'm convinced it's something not sterilized properly in Malaysia.
CAN INCUBATION BE 10 YEARS+?
(btw I'm non drinker, non-druggie, non-needle-sharer, non-playing-around-with-women-er)
Bill
Yes, the Riba dose was from Wikipedia I think - weight would be the variable factor.
I was born with weak lungs and had problems from my first week of life.
I was the weak kid at school and often sat out during PE/PT/sports/etc.
HCV real time PCR = 476; normal is <43 if that means anything.
All the other nasties were 60 years before the HepC was a glint in the devil's eye :-)
(couldn't resist that; I like laughing adversity in the face!)
Hmmmm - return to Australia? Thanks for the seed thought.
You've brought up something:
I had a transfusion in Australia June 2000 - over 10 years ago.
I've also had canula and injections and minor ops by the score last few years in Malaysia. The Malaysian hospitals are trying to blame the transfusion 10 years ago.
I'm convinced it's something not sterilized properly in Malaysia.
CAN INCUBATION BE 10 YEARS+?
(btw I'm non drinker, non-druggie, non-needle-sharer, non-playing-around-with-women-er)
Bill
"Ribivirin 1,000-2,000 mg/day (I weigh 70kg)
x 3 weekly"
Welcome to the site Bill. I believe the Riba dosage you quoted may be incorrect(?). It's usually twice daily and dosage based on weight (@ 55kg I took 1000mg daily).
Is it possible for you to return to Oz to treat, or move closer to a health provider? With your other health problems (some of which may be related to the HVC if you've carried the virus for a long time), a better support network may carry a better outcome. Apart from the V/load, do you have any idea of the state of your liver? (As my liver deteriorated, I had sx's seemingly unrelated, my absorption of nutrients was lower, and I was very low of B12 and Vit D, constipated, among other things).
I hope you manage to work out a way to treat.
x 3 weekly"
Welcome to the site Bill. I believe the Riba dosage you quoted may be incorrect(?). It's usually twice daily and dosage based on weight (@ 55kg I took 1000mg daily).
Is it possible for you to return to Oz to treat, or move closer to a health provider? With your other health problems (some of which may be related to the HVC if you've carried the virus for a long time), a better support network may carry a better outcome. Apart from the V/load, do you have any idea of the state of your liver? (As my liver deteriorated, I had sx's seemingly unrelated, my absorption of nutrients was lower, and I was very low of B12 and Vit D, constipated, among other things).
I hope you manage to work out a way to treat.
Big thank you for support fellow "Heppites"(?) :-)
Seriously I am so appreciative.
btw TRISH777
It's like this: It's so serious, if I don't laugh at myself, I cry!
I have serious lung problems with 'estimated lung age' of 120 years old.
had 5 false positives for TB, got osteoporosis from prescribed cortisones,
my adrenal function is down (not quite adrenal insufficiency but maybe adrenal fatigue.)
I also have incredibly troublesome dentures (can't get screws as bone structure wouldn't hold), piles, urinary tract issues, sore back & sleeping problems.
SO I tell people: "Don't worry, it only hurts when I:
breath,
walk,
stand,
sit
lie down
stay awake
try to sleep
eat
wee
poo
... but when I'm not doing any of those things, I'm OK :-)
Bill
Seriously I am so appreciative.
btw TRISH777
It's like this: It's so serious, if I don't laugh at myself, I cry!
I have serious lung problems with 'estimated lung age' of 120 years old.
had 5 false positives for TB, got osteoporosis from prescribed cortisones,
my adrenal function is down (not quite adrenal insufficiency but maybe adrenal fatigue.)
I also have incredibly troublesome dentures (can't get screws as bone structure wouldn't hold), piles, urinary tract issues, sore back & sleeping problems.
SO I tell people: "Don't worry, it only hurts when I:
breath,
walk,
stand,
sit
lie down
stay awake
try to sleep
eat
wee
poo
... but when I'm not doing any of those things, I'm OK :-)
Bill
I meant to say 180mcg shot of Roche not 180mIU = AUD $ 295 here in Indo ...
Also ,your govt has a social medicine program doesn't it ?
When I checked about doing Tx in Oz , because i am American , the price quoted was the same as the states .. been here in Indo 12 yrs. , to many responsibilities here , can't move far just to do this Tx ...
Good luck Bill !
Also ,your govt has a social medicine program doesn't it ?
When I checked about doing Tx in Oz , because i am American , the price quoted was the same as the states .. been here in Indo 12 yrs. , to many responsibilities here , can't move far just to do this Tx ...
Good luck Bill !
I'm in Indonesia ...
As Murariji and the rest say ... do your homework first ie: how much damage do you have to your liver ?
Maybe you just don't like the idea of having a virus in your body and want to try to get rid of it ...
Everybody's reaction is different - I would not be doing it now if I did not have to .....
For reference , I'm 53yrs., 1a - here in Indonesia the cost of 1 shot Roche 18 mlU , bought from the local doctor , in AUD $$ = $295
If Tx - 24 wks = AUD $7080 ++
As far as I know Tx in Indo is about half the cost of Tx in Oz or the U.S.
+ blood tests here for the "normal" values to keep an eye on are around $25 per blood panel , TSHs add $15 , PCR RNA accurate to <15 IU/ml apx. $180
sometimes I have the results emailed if I can't for some reason get back to pick them up that week
I would think Malaysia prices would be close to or the same as Indo as we are next door to each other .... in developing nations ...
If you want to check in K.L. here is the name of one doc's name I got off the net (for what that is worth) ...
Physicians who treat Hepatitis C
Malaysia
Ismail Merican, MBBS
Senior Consultant Physician
Hospital Kuala Lumpur
Kuala Lumpur, Malaysia
Phone: 603.290.5228
Disclaimer: The physicians included in this website are those who received personal recommendations submitted by fellow hepatitis patients. The author of this website cannot assure the accuracy of information provided them by third parties, since opinions are subjective and may be incomplete. The omission from this website of particular physicians does not mean that they are not competent or reputable. Author is not always informed of doctors no longer in practice, therefore we recommend checking to see if the patient recommended physician is still available.
As Murariji and the rest say ... do your homework first ie: how much damage do you have to your liver ?
Maybe you just don't like the idea of having a virus in your body and want to try to get rid of it ...
Everybody's reaction is different - I would not be doing it now if I did not have to .....
For reference , I'm 53yrs., 1a - here in Indonesia the cost of 1 shot Roche 18 mlU , bought from the local doctor , in AUD $$ = $295
If Tx - 24 wks = AUD $7080 ++
As far as I know Tx in Indo is about half the cost of Tx in Oz or the U.S.
+ blood tests here for the "normal" values to keep an eye on are around $25 per blood panel , TSHs add $15 , PCR RNA accurate to <15 IU/ml apx. $180
sometimes I have the results emailed if I can't for some reason get back to pick them up that week
I would think Malaysia prices would be close to or the same as Indo as we are next door to each other .... in developing nations ...
If you want to check in K.L. here is the name of one doc's name I got off the net (for what that is worth) ...
Physicians who treat Hepatitis C
Malaysia
Ismail Merican, MBBS
Senior Consultant Physician
Hospital Kuala Lumpur
Kuala Lumpur, Malaysia
Phone: 603.290.5228
Disclaimer: The physicians included in this website are those who received personal recommendations submitted by fellow hepatitis patients. The author of this website cannot assure the accuracy of information provided them by third parties, since opinions are subjective and may be incomplete. The omission from this website of particular physicians does not mean that they are not competent or reputable. Author is not always informed of doctors no longer in practice, therefore we recommend checking to see if the patient recommended physician is still available.
""Isn't someone going to tell me 'welcome to the world of druggies that shoot up?" :-) "
NO. This is not like that. I wouldn't want to equate this in any way at all with that. In fact, some folks have to work rather hard to mentally separate this....from that. 'Nuff said. These are subcutaneous injections which mean you inject into your fat. Not a vein. Most of us injected and do inject our own interferon - some have a partner do it for them but practically nobody has to go to the doc's office to have it done. You "pinch an inch" in your abdomen most commonly, needle into your fat and push the plunger. Hold it in place for a bit afterwards to ensure it's properly disseminated and then extract the needle. Not hard.
If you have proper refrigeration, you can keep a certain amount of dosages in your fridge and replenish on a schedule but always well before you run out. It will take some planning.
You'll also want to make sure you get your blood levels checked on a regular basis to keep an eye on your red and white blood cells and you should be watched by a hepatologist. Even here in Canada with my treatment centre a 1-2 hour drive one-way depending on traffic, it made sense to at least have the blood tests done locally so I didn't have to travel for those and the results sent to my treatment centre who would read them and call me with them and what it meant for my treatment.
Question - that's an odd level for a viral load - 476. Is this a recent infection? Reason I ask is, if yes, depending where you are in the acute phase, you could yet clear it.
I'm not sure if you know this but having a viral load alone is not considered a viable reason on it's own to go through treatment. There is the amount of liver damage you have along with your current situation in life to be considered. It's an expensive treatment and a serious treatment with regards to length and how it may impact your health and your day to day ability to maintain the important things. So if you are looking to proceed with treatment solely on the basis that you have detectable virus in your blood, there are other factors to consider. Hep C is generally a slow-moving disease and, as Murariji says, you may want to consider waiting if you expect to be in a situation down the road where your conditions for treatment will be more favourable.
Trish
NO. This is not like that. I wouldn't want to equate this in any way at all with that. In fact, some folks have to work rather hard to mentally separate this....from that. 'Nuff said. These are subcutaneous injections which mean you inject into your fat. Not a vein. Most of us injected and do inject our own interferon - some have a partner do it for them but practically nobody has to go to the doc's office to have it done. You "pinch an inch" in your abdomen most commonly, needle into your fat and push the plunger. Hold it in place for a bit afterwards to ensure it's properly disseminated and then extract the needle. Not hard.
If you have proper refrigeration, you can keep a certain amount of dosages in your fridge and replenish on a schedule but always well before you run out. It will take some planning.
You'll also want to make sure you get your blood levels checked on a regular basis to keep an eye on your red and white blood cells and you should be watched by a hepatologist. Even here in Canada with my treatment centre a 1-2 hour drive one-way depending on traffic, it made sense to at least have the blood tests done locally so I didn't have to travel for those and the results sent to my treatment centre who would read them and call me with them and what it meant for my treatment.
Question - that's an odd level for a viral load - 476. Is this a recent infection? Reason I ask is, if yes, depending where you are in the acute phase, you could yet clear it.
I'm not sure if you know this but having a viral load alone is not considered a viable reason on it's own to go through treatment. There is the amount of liver damage you have along with your current situation in life to be considered. It's an expensive treatment and a serious treatment with regards to length and how it may impact your health and your day to day ability to maintain the important things. So if you are looking to proceed with treatment solely on the basis that you have detectable virus in your blood, there are other factors to consider. Hep C is generally a slow-moving disease and, as Murariji says, you may want to consider waiting if you expect to be in a situation down the road where your conditions for treatment will be more favourable.
Trish
I bought my first injection from a hospital, it was from Shering Plough and cost the equivalent of US $330. The next I got directly from the company rep and cost $288, Then I found that they were selling me readypens, which were convenient but cost more than the kit form which only cost $255. They may have a similar deal in Malaysia. The ribavirin was free, and I got a free injection after every 7, so I only had to pay for 21. Do your homework there and you may be able to save some money. Roche cost more, and I didn't like the guy in the office anyway!
I am new here, but was in almost identical circumstances in India, living almost 5 hours travel by bus from Calcutta. The injection is the least of your worries. The combination of Interferon and ribavirin does a variety of different things to your body, particularly in my case the platelet count and white blood cell count. You may need to check these regularly and take additional meds (neopogen) if they drop too much. Anemia may also be an issue.
I found it good to go in to Calcutta, take a shot there, and carry two with me in a cooler, keep them in a fridge,(watch out for power cuts of longer than 6 hours), do them, one each week and then go back in for the next etc, and get a blood check done.
I found it best to have some paracetamol, and then take the shot just when I was ready to leave, that way I could be home before it really kicked in. I seem to remember Malaysia in general is not as chaotic as India, but it's no fun travelling in crowded buses or trains while full of INF/riba especially in the middle of summer.
If your liver is not seriously threatened, it would be worth considering delaying treatment if you are likely to be better located later.
Whatever you decide there is a wealth of knowledge here, so take advantage of it, as it may be a rough 24 weeks.
Welcome.
I found it good to go in to Calcutta, take a shot there, and carry two with me in a cooler, keep them in a fridge,(watch out for power cuts of longer than 6 hours), do them, one each week and then go back in for the next etc, and get a blood check done.
I found it best to have some paracetamol, and then take the shot just when I was ready to leave, that way I could be home before it really kicked in. I seem to remember Malaysia in general is not as chaotic as India, but it's no fun travelling in crowded buses or trains while full of INF/riba especially in the middle of summer.
If your liver is not seriously threatened, it would be worth considering delaying treatment if you are likely to be better located later.
Whatever you decide there is a wealth of knowledge here, so take advantage of it, as it may be a rough 24 weeks.
Welcome.
Multiple Thanks:
Bill1954: - $14k -aaaghh! Bill1950!
Spoon5665: Thanks - I also checked PharmacyEscrow who I have done work for previously as a copywriter. I written reports on various problem illnesses and solution medications. www.billoliver.net/SME.html
Diane12855 - Thanks. Nice to know.
"Isn't someone going to tell me 'welcome to the world of druggies that shoot up?" :-)
hcvJames: BIG thanks. We'll take an ice pack to the hospital 4 hrs away.
As a husband of ex-government servant, I've been getting free health care to now.
I'll try and convince them I'm not going to sell the stuff!
(With asthma puffers, we have to return the empty puffers. They are concerned we will sell it.)
Bill
Bill1954: - $14k -aaaghh! Bill1950!
Spoon5665: Thanks - I also checked PharmacyEscrow who I have done work for previously as a copywriter. I written reports on various problem illnesses and solution medications. www.billoliver.net/SME.html
Diane12855 - Thanks. Nice to know.
"Isn't someone going to tell me 'welcome to the world of druggies that shoot up?" :-)
hcvJames: BIG thanks. We'll take an ice pack to the hospital 4 hrs away.
As a husband of ex-government servant, I've been getting free health care to now.
I'll try and convince them I'm not going to sell the stuff!
(With asthma puffers, we have to return the empty puffers. They are concerned we will sell it.)
Bill
Remember in shipping the interferon must remain refrigerated. Usually it's shipped surrounded by ice packs and insulation. In the US it's shipped overnight. Is the mail that good in your part of Malay? Just bringing out another consideration.
I self inject in my abdomen... no problem at all. The first couple of shots made me kind of nervous but now that I'm on shot 37, it's a piece of cake.
Diane
Diane
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Patients in most developed nations self-inject the interferon. It’s a subcutaneous injection; the process is similar to injecting insulin. Physicians or nurses aren’t typically involved with injection procedure itself.
These medications are relatively expensive; here in the States, the cost for 24 weeks pegylated interferon/ribavirin, if purchased by cash out of pocket would cost (roughly) USD $14,000. (AUD $13,675).
The interferon requires refrigeration; it is shipped overnight in cold-pack cooler containers.
Welcome to the discussion group, by the way-
Bill