Aa
Anyone heard of Lawrence Rothman in Miami
Saw a recommendation for Lawrence Rothman in Miami, heard he was doing extensive Hep C work. Any one know him?
First, viral load isn't a factor in when to treat, esecially in the middle range where you are. Once you are on treatment, it's a marker to see how the IFN is working.
If and when to treat is an individual decision. A lot of the factors in making that decision have been laid out in this thread, but in the end, the choice is yours. Some people will want to treat immediately, regardless of the amount of damage they have, others can co-exist quite well with the virus indefinitely. Without a biopsy result to gauge the damage, what's posted above is probably the best advice you can expect.
Good luck with it.
If and when to treat is an individual decision. A lot of the factors in making that decision have been laid out in this thread, but in the end, the choice is yours. Some people will want to treat immediately, regardless of the amount of damage they have, others can co-exist quite well with the virus indefinitely. Without a biopsy result to gauge the damage, what's posted above is probably the best advice you can expect.
Good luck with it.
So I have not heard a response yet from any of you.. should I take the chance and not do treatment now even though my load is 1,000,000?
I'd love to live in Florida..... but it is so expensive....
Or is it? Right now is a good time to buy though, right? Prices are down way down. Why is that? (answer) More houses for sale than buyers.
In a very few years there will be multiple HCV treatments. I think that may cause some "mark downs". Furthermore....... there are second generation drugs that are nipping at the heels (or heals ; )) of the first releases. Sherring-Plough already has a second genration PI coming up behind Boceprevir and if Vertex is correct they may start a "stat-c" dual PI trial this year yet. What might the 2 companies do with the first generation assets? Sell them for capitol and whoever buys them could run a blue light special.....discount them. And so..... the wave of good drugs just keeps coming!!! (if I may sound so 60ish)
Yes!!!! I agree that it is not a forgone conclusion about drug pricing BUT keep in mind;
1) fewer will have to retreat (that = cost savings)
2) there exists a potential for cutting 24 weeks off of a conventional geno 1 TX
(24 weeks of RBV and IFN and doctor visits and potentially rescue drugs etc)
3) Reduced cost of other factors; rescue drugs, ot treating a myriad of post TX
symptoms or issues related to extended chemotherapy.
4) There may be the convenience factor which insurance would not pay....perhaps.
I can almost see lawsuits if insurance would not provide coverage of a treatment.
I mean they could also pay for leeches instead of the cost of phlebotomies. ; )
The topic almost begs a seque into how the insurance company bleeds its policy holders and provides substandard coverage....all while paying itself criminal salaries and building huge skyscrapers in major cities.
I don't know that it is a foregone conclusion that the drugs will be so expensive that they will not be covered. There are some things which suggest that the price could even become less $ to treat.
Example; lets say that current tx for 1 year costs 50k for IFN and RBV.
Now...... cut the TX time in half. But lets say that Vertex says that 12 weeks of TVR is worth 25K.
IF so..... the triple therapy would cost the same as SOC with IFN and RBV- exact same cost.
The insurance company is happy because they will have more successes and will not have to pay for as many retreats or other extrahepatic disease issues, yet they pay no more and probably less.
The customer is happy because in addition to a higher SVR rate they may have shorter TX times and a shorter recover + a possible decrease incidence rate of post tx related issues (knock on wood; fewer issues and a quicker recovery.
Even the Govt may be happier if there are less people on disability and able to continue to be productive tax paying citizens.
I'll be interested to see what happens....
Willy
Or is it? Right now is a good time to buy though, right? Prices are down way down. Why is that? (answer) More houses for sale than buyers.
In a very few years there will be multiple HCV treatments. I think that may cause some "mark downs". Furthermore....... there are second generation drugs that are nipping at the heels (or heals ; )) of the first releases. Sherring-Plough already has a second genration PI coming up behind Boceprevir and if Vertex is correct they may start a "stat-c" dual PI trial this year yet. What might the 2 companies do with the first generation assets? Sell them for capitol and whoever buys them could run a blue light special.....discount them. And so..... the wave of good drugs just keeps coming!!! (if I may sound so 60ish)
Yes!!!! I agree that it is not a forgone conclusion about drug pricing BUT keep in mind;
1) fewer will have to retreat (that = cost savings)
2) there exists a potential for cutting 24 weeks off of a conventional geno 1 TX
(24 weeks of RBV and IFN and doctor visits and potentially rescue drugs etc)
3) Reduced cost of other factors; rescue drugs, ot treating a myriad of post TX
symptoms or issues related to extended chemotherapy.
4) There may be the convenience factor which insurance would not pay....perhaps.
I can almost see lawsuits if insurance would not provide coverage of a treatment.
I mean they could also pay for leeches instead of the cost of phlebotomies. ; )
The topic almost begs a seque into how the insurance company bleeds its policy holders and provides substandard coverage....all while paying itself criminal salaries and building huge skyscrapers in major cities.
I don't know that it is a foregone conclusion that the drugs will be so expensive that they will not be covered. There are some things which suggest that the price could even become less $ to treat.
Example; lets say that current tx for 1 year costs 50k for IFN and RBV.
Now...... cut the TX time in half. But lets say that Vertex says that 12 weeks of TVR is worth 25K.
IF so..... the triple therapy would cost the same as SOC with IFN and RBV- exact same cost.
The insurance company is happy because they will have more successes and will not have to pay for as many retreats or other extrahepatic disease issues, yet they pay no more and probably less.
The customer is happy because in addition to a higher SVR rate they may have shorter TX times and a shorter recover + a possible decrease incidence rate of post tx related issues (knock on wood; fewer issues and a quicker recovery.
Even the Govt may be happier if there are less people on disability and able to continue to be productive tax paying citizens.
I'll be interested to see what happens....
Willy
Also being in South Florida (same town) and having treated twice, I have a minor suggestion. If you become committed to treat at some point, it might be better to not start in the summer. Although you would likely treat for a year and hit both of our seasons there is a period in which you acclimate yourself to the routine. I found it better to have that experience when it's not so hot. But with everything else about hcv, your mileage may vary.
thanks for the info, I think my initial thoughts are that I would take the treatment, I am afraid to wait, nervous about what the increased viral load could do to my body and liver. BUT is the treatment and its side effects equally as damaging?
I retired very early a couple of years ago, have a pretty stable and relaxed home life, so the treatment would not affect me much as far as interrupting work, or children responsibilities since my kids are grown.
My experience as a HR exec is that insurance companies tend to label new drugs "experimental" as a way of postponing covering those drugs until costs come down.
I retired very early a couple of years ago, have a pretty stable and relaxed home life, so the treatment would not affect me much as far as interrupting work, or children responsibilities since my kids are grown.
My experience as a HR exec is that insurance companies tend to label new drugs "experimental" as a way of postponing covering those drugs until costs come down.
I think that FlGuy’s thoughts about insurance inclusion into the standard of care are very interesting; I was talking to someone recently about his very subject. Just because any new pharmaceuticals are approved by the FDA doesn’t really make them more accessible to us if the insurance actuaries don’t see fit to cover them. No doubt these will add to the expense of therapy; but will they increase efficacy to the point where they become a bargain to the industry? Will the added SVR rates justify increases in initial layout? Hmm…
Good point; and one that hasn’t been dissected much in these groups. I suppose one could look at history; I don’t have access to data about the introduction of pegylated IFN; was that adopted by the industry without much fuss?
Bill
Good point; and one that hasn’t been dissected much in these groups. I suppose one could look at history; I don’t have access to data about the introduction of pegylated IFN; was that adopted by the industry without much fuss?
Bill
Bill makes a good point about what your intentions are.
There always seems to be a current thread about the 'new' meds that might be coming down the pike. It's appears that the 'new' stuff will likely make treatment shorter and more effective.
I think there's a little more to it. A personn also needs to evaluate other existing conditions that surround them; family demands, employment, other health conditions and so on. Another point for which I'm not clear...let's say the new meds come out in a year or two, does that mean that a person's health insurance will 'automatically' cover the new stuff? I don't know. It's bound to make treatment more expensive, maybe. There's a whole bunch of head-spinning stuff to wade through.
There always seems to be a current thread about the 'new' meds that might be coming down the pike. It's appears that the 'new' stuff will likely make treatment shorter and more effective.
I think there's a little more to it. A personn also needs to evaluate other existing conditions that surround them; family demands, employment, other health conditions and so on. Another point for which I'm not clear...let's say the new meds come out in a year or two, does that mean that a person's health insurance will 'automatically' cover the new stuff? I don't know. It's bound to make treatment more expensive, maybe. There's a whole bunch of head-spinning stuff to wade through.
Hi Sandy,
I think the key to this is whether you intend to undergo treatment or not. If you’re planning on treating anyway, a good case could be made to skip *any* liver staging and go for the cure; if you achieve SVR, none of this really matters anyway… it becomes a moot point of sorts. If you intend to postpone/delay therapy, knowledge of ones damage is much crucial; it can provide information as to the urgency of treatment.
Sorry I can’t help with south Florida doctors; you’re in good hands with FlGuy, though.
Take care—
Bill
thanks a bunch Flguy..
i got my results yesterday, 1a genotype, 1,000,000 viral load, from the blood test they said little to no fibrosis
should I ask for another more thorough test for liver damage?
i got my results yesterday, 1a genotype, 1,000,000 viral load, from the blood test they said little to no fibrosis
should I ask for another more thorough test for liver damage?
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