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Hep C Patients Tax Medical System----(And Other Posts)
Hepatitis C Patients Taxing Medical System
FRIDAY, Dec. 30 (HealthDay News) -- The use of health-care resources by hepatitis C patients in the United States has been increasing by 25 percent to 30 percent a year, says a Duke University study in the December issue of Hepatology.
About 3 million people in the United States have chronic hepatitis C virus (HCV), and many of them contracted it in the 1970s, before testing and safe needle-sharing practices became widespread. Health experts have been predicting an increasing impact on the health system as these people grow older.
The Duke researchers analyzed HCV patient hospitalization trends from 1994 to 2001, HCV-related doctors' visits from 1996 to 2002, and prescription drug data for HCV patients from 1998 to 2000.
The study found that HCV-related hospitalizations, hospital days, total charges and deaths increased by more than 20 percent per year. That's three times higher than all-cause hospitalizations. The largest increases were seen in patients in their 40s and 50s, who spent more time in a hospital, incurred greater costs, and died more often than HCV patients in other age groups.
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FRIDAY, Dec. 30 (HealthDay News) -- The use of health-care resources by hepatitis C patients in the United States has been increasing by 25 percent to 30 percent a year, says a Duke University study in the December issue of Hepatology.
About 3 million people in the United States have chronic hepatitis C virus (HCV), and many of them contracted it in the 1970s, before testing and safe needle-sharing practices became widespread. Health experts have been predicting an increasing impact on the health system as these people grow older.
The Duke researchers analyzed HCV patient hospitalization trends from 1994 to 2001, HCV-related doctors' visits from 1996 to 2002, and prescription drug data for HCV patients from 1998 to 2000.
The study found that HCV-related hospitalizations, hospital days, total charges and deaths increased by more than 20 percent per year. That's three times higher than all-cause hospitalizations. The largest increases were seen in patients in their 40s and 50s, who spent more time in a hospital, incurred greater costs, and died more often than HCV patients in other age groups.
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(Continued from above)
The study also found that doctor office visits by HCV patients increased by 36 percent a year, and spending on HCV drug therapy rose from $78 per $100,000 of new prescriptions in 1998 to $259 per $100,000 in 2000.
"The study documents accelerating use of health-care resources by patients with HCV, indicating that the future burden of HCV infection will match and may exceed analysts' forecasts," the study authors wrote.
More information
The American Academy of Family Physicians has more about hepatitis C.
The study also found that doctor office visits by HCV patients increased by 36 percent a year, and spending on HCV drug therapy rose from $78 per $100,000 of new prescriptions in 1998 to $259 per $100,000 in 2000.
"The study documents accelerating use of health-care resources by patients with HCV, indicating that the future burden of HCV infection will match and may exceed analysts' forecasts," the study authors wrote.
More information
The American Academy of Family Physicians has more about hepatitis C.
Hi there.
There is no doubt that this virus is costly,but wht is scarey is the number of people who dont realize they have this hcv.If they dont know then their not taking steps to not infect others!In 10 more years the no. will go thru the roof!Hopefully the newer tx will be approved and this problem can be resolved.
There is no doubt that this virus is costly,but wht is scarey is the number of people who dont realize they have this hcv.If they dont know then their not taking steps to not infect others!In 10 more years the no. will go thru the roof!Hopefully the newer tx will be approved and this problem can be resolved.
Just wait until VX-950 and the like are available
I read an interesting article several months ago, which stated that once the newer HCV drugs like VX-950 become available, that there will not be enough hepatology specialists to treat all the people that will be seeking tx. Non-responders and the many untreated people who are have been waiting for these drugs will overwhelm the current system.
For me, it took me about 4 months to see my hepatologist for the first time. One might expect this to more than double.
I read an interesting article several months ago, which stated that once the newer HCV drugs like VX-950 become available, that there will not be enough hepatology specialists to treat all the people that will be seeking tx. Non-responders and the many untreated people who are have been waiting for these drugs will overwhelm the current system.
For me, it took me about 4 months to see my hepatologist for the first time. One might expect this to more than double.
I agree that they've not even begun to see the beginning of the numbers of people who have this disease.
Certainly just in here alone how many people have no obvious way that they contracted it? Had no knowledge or suspicion that they did and were only diagnosed because of LUCK?
Watching an ER rerun the other day the doctor got cut on someone bleeding and they immediately ran an HIV test. I thought right away but what about any Hep test...that is blood borne too?
At this point I think they WANT this to be seen as an IVDU disease just like HIV being a "gay" disease in the 80s. I'm almost becoming a conspiracy theorist the way I look at the way we are treated.
Look at every woman in America who's gone to a nail salon alone? Every single one of them has a chance of contracting this and has NO idea whatsoever. But you don't see things like that mentionned.
It REALLY pisses me off how ignorant America is - but at one time I admit I WAS TOO. That's why it's important that we be honest about our disease and spread the correct news.
Certainly just in here alone how many people have no obvious way that they contracted it? Had no knowledge or suspicion that they did and were only diagnosed because of LUCK?
Watching an ER rerun the other day the doctor got cut on someone bleeding and they immediately ran an HIV test. I thought right away but what about any Hep test...that is blood borne too?
At this point I think they WANT this to be seen as an IVDU disease just like HIV being a "gay" disease in the 80s. I'm almost becoming a conspiracy theorist the way I look at the way we are treated.
Look at every woman in America who's gone to a nail salon alone? Every single one of them has a chance of contracting this and has NO idea whatsoever. But you don't see things like that mentionned.
It REALLY pisses me off how ignorant America is - but at one time I admit I WAS TOO. That's why it's important that we be honest about our disease and spread the correct news.
I also do think there would be a rush to treat. My Primary Care Doc who is not a specialist treats many HCV patients already with current SOC. He told me last time that he had just finished successfully tx'ing 2 geno 1's for 18 months. He does have contact with some of the leading hepatologists, so he is up to date on many things. And, I keep him up to date on 950.
I think in the next few weeks VRTX will have data from the 1b, which I expect to be very good (IFN and 950). My reasons for the expected soon release is, that they have stated they would have data early in 1q 2006, and another larger phase 2 trial is scheduled to start later in January. I think they want to use this 1b trial to help set the course for that trial. They are presenting at a conference on 1/9, so I will be listening to that.
I think that over a longer period of time, HCV has the potential to burden the health care system LESS than now. Why?
Many who have it now, got it from Vietnam, or the 60's, 70's, or 80's, as I got it from blood transfusions back then. There is now blood screening that didn't exist then. Once a good cure is out there, more and more people should respond, thus stopping the progression of the disease. Also, more would opt for tx, and hopefully more will be caught early because it would be much better tx'd. A shorter tx should also mean less "collateral" issues, like no side meds because of the effects of riba (which I don't see as necessary for the new tx's), less time out on disability, less lost productivity, etc. All of that depends on a shorter good tx, which I believe is in the future.
Some pharma analysts think the acting FDA chief might streamline important meds to make approval faster and easier, especially in areas of cancer, HIV and HCV, and some have mentioned VRTX as being a beneficiary of that. I am not sure a faster timeline would necessarily get the drug to market faster, as there is MUCH work to be done, scale up is a major task, and you have to make sure you can supply the market after launch, especially since demand might be high. It's not as easy as it sounds.
May all have a happy and HEALTHY New Year.
I think in the next few weeks VRTX will have data from the 1b, which I expect to be very good (IFN and 950). My reasons for the expected soon release is, that they have stated they would have data early in 1q 2006, and another larger phase 2 trial is scheduled to start later in January. I think they want to use this 1b trial to help set the course for that trial. They are presenting at a conference on 1/9, so I will be listening to that.
I think that over a longer period of time, HCV has the potential to burden the health care system LESS than now. Why?
Many who have it now, got it from Vietnam, or the 60's, 70's, or 80's, as I got it from blood transfusions back then. There is now blood screening that didn't exist then. Once a good cure is out there, more and more people should respond, thus stopping the progression of the disease. Also, more would opt for tx, and hopefully more will be caught early because it would be much better tx'd. A shorter tx should also mean less "collateral" issues, like no side meds because of the effects of riba (which I don't see as necessary for the new tx's), less time out on disability, less lost productivity, etc. All of that depends on a shorter good tx, which I believe is in the future.
Some pharma analysts think the acting FDA chief might streamline important meds to make approval faster and easier, especially in areas of cancer, HIV and HCV, and some have mentioned VRTX as being a beneficiary of that. I am not sure a faster timeline would necessarily get the drug to market faster, as there is MUCH work to be done, scale up is a major task, and you have to make sure you can supply the market after launch, especially since demand might be high. It's not as easy as it sounds.
May all have a happy and HEALTHY New Year.
National surveillance for hepatitis C suffers from a lack of consistent reporting criteria. In the absence of hepatitis C
Thank you for posting that. It was in words I could understand and they frightened me so much.
I wish that this disease had more coverage in the media, unfortunately it will take somebody coming out with it who is very very famous most likely for that to happen. Much more important than...Pam Anderson...who seems a likely candidate for any communicable disease.
People need to know or they will never protect themselves.
I wish that this disease had more coverage in the media, unfortunately it will take somebody coming out with it who is very very famous most likely for that to happen. Much more important than...Pam Anderson...who seems a likely candidate for any communicable disease.
People need to know or they will never protect themselves.
"As it stands now the chances of the FDA speeding up any drug approval process is slim to nil as if one were to look back over the years it was at that bequest of the AIDS movement that a faster approval times were sought as 1000
Thank you, your post is much appreciated. It is good to hear it is working/has worked for you.
I have said on other posts (and it prob. gets forgotten because I talk so much about 950) that I think ANYTHING in development should be welcomed, as not everything works for everyone. I just want HCV to become a thing of the past, as I would not wish it on anyone. I can be rough on current tx, but current tx has been rough on many. I hope no one misinterprets that, because it is what we have now, and is needed, and has helped many. I don't care how people are cured. I just want to see people cured.
Spending a little (30k) now for tx, can save a whole lot later. Transplants cost 300K and upwards, with a lifetime of meds. That isn't even including all the other costs associated with having HCV from a medical standpoint. And, there is of course, the economical angle to.
I have said on other posts (and it prob. gets forgotten because I talk so much about 950) that I think ANYTHING in development should be welcomed, as not everything works for everyone. I just want HCV to become a thing of the past, as I would not wish it on anyone. I can be rough on current tx, but current tx has been rough on many. I hope no one misinterprets that, because it is what we have now, and is needed, and has helped many. I don't care how people are cured. I just want to see people cured.
Spending a little (30k) now for tx, can save a whole lot later. Transplants cost 300K and upwards, with a lifetime of meds. That isn't even including all the other costs associated with having HCV from a medical standpoint. And, there is of course, the economical angle to.
You know, I think we dilute the case for enhanced research and testing when we repeatedly cite nail salons and dental procedures as major transmission sources. I appreciate the efforts to erase the stigma, but let's keep it real.
Agreed, dental transmissions happen. But please. I think I read the CDC identified 40 some-odd documented dental transmissions in 2004. Now surely there is vast under reporting going on there. But still, how many MILLIONS of dental procedures occur every single day?
So we have 40 dental transmissions per anum. By Andy's stats, 8 of those cases will progress to advanced liver problems, (assume that is absent of treatment, current treatment would halve the number to 4). Maybe I have these numbers wrong, and if I do, my apologies. But if these numbers are anything close to accurate, even within several orders of magnitude, I'd venture that you have a higher risk of dying from a baterial infection conrtacted at the dentist than you do of Hep C.
My 2 cents.
Agreed, dental transmissions happen. But please. I think I read the CDC identified 40 some-odd documented dental transmissions in 2004. Now surely there is vast under reporting going on there. But still, how many MILLIONS of dental procedures occur every single day?
So we have 40 dental transmissions per anum. By Andy's stats, 8 of those cases will progress to advanced liver problems, (assume that is absent of treatment, current treatment would halve the number to 4). Maybe I have these numbers wrong, and if I do, my apologies. But if these numbers are anything close to accurate, even within several orders of magnitude, I'd venture that you have a higher risk of dying from a baterial infection conrtacted at the dentist than you do of Hep C.
My 2 cents.
Harming the HCV community is I think a fair assesment, as those who look to a drug to solve what is an enormous problem is very simplistic to say the least. There are no silver bullets. Current medications are effective in far less than 50% of those who can access current medications. The cost in human lives is enormous. The cost to the economy is staggering. HCV is a multifaceted disease, as even those who have obtained a SVR, many have lingering problems. I could go on and on , but as it is New Years, I wish all those a happy and healthier 2006.
Yes, I read that this morning, but I wasn't quite sure what to make of it. I think they really need to elaborate on that more than the article did. I do seriously question the cost of what they mentioned for HCV-going from 40k to $20. The last time I bought hybrid tomato seeds they almost cost that much! LOL
I know it was a hypothetical, but somehow, I remain very skeptical.
A while back, Japanese researchers found something in the leaf of green tea that was active against HIV (drinking it had no effect).
I also once had a link that some were using mistletoe and green tomato plants for long term usage (and success) in HCV. I don't know if I still have the link. Medicine used to be plant-based, and I believe that is an area that is overlooked. But, one problem is that pharma cos. can't patent herbs, so there is no incentive to study them.
I know it was a hypothetical, but somehow, I remain very skeptical.
A while back, Japanese researchers found something in the leaf of green tea that was active against HIV (drinking it had no effect).
I also once had a link that some were using mistletoe and green tomato plants for long term usage (and success) in HCV. I don't know if I still have the link. Medicine used to be plant-based, and I believe that is an area that is overlooked. But, one problem is that pharma cos. can't patent herbs, so there is no incentive to study them.
Treated 3 times, first with rebetron combo on a trial in the last century, then agian with daily injections, then with Pegasys combo on a trial. For a grand total of 553 shots give or take a few.
In this case I'm relying on the actuarial analysis of the CDC. Do you have data discrediting thiers?
I have several letters from those who represent the American Dental Association, The Canadian Dental Association etc, asking to cease and desist. Personally I wish they would clean up their act and stop self policing, by letting an outside agency check to ensure all dentists are not spreading disease.
On the other hand, it's New Years and well in a few hours no more transmission og HCV will happen in 2005. Sleep well.
On the other hand, it's New Years and well in a few hours no more transmission og HCV will happen in 2005. Sleep well.
Until the CDC establishes HCV seroprevalence baseline rates using periodic surveys that include population-based studies, I would suggest their info cannot be validated. Intensive surveillance is very expensive and to date the CDC has relied on HMO
You know, I think we dilute the case for enhanced research and testing when we repeatedly cite nail salons and dental procedures as major transmission sources
I like to site THAT one in particular because it's an ANYONE can get it type of source of infection - a sort where say wealthy women could get it...instead of the usual attitude of it being a drug addicts disease.
People who think in that ignorant fashion are the people who hurt us the most as they don't think it would ever happen to someone of "their class" of people compared to "ours". It assumes everyone on this board is a "less than desirable" type element which we know is patently untrue and paints a picture of the "well then let them die they brought it on themselves" attitude similar to the "gay bathhouses" of the 80s HIV.
That is the only point I was trying to make. It's an ANYONE disease but people do NOT see that whatsoever.
(PS Not to offend anyone yes I did drugs in the 80s and that might be where I got this, or from my xhusband who's had it for 25 years or from transfusions I've received. I dont know.)
I like to site THAT one in particular because it's an ANYONE can get it type of source of infection - a sort where say wealthy women could get it...instead of the usual attitude of it being a drug addicts disease.
People who think in that ignorant fashion are the people who hurt us the most as they don't think it would ever happen to someone of "their class" of people compared to "ours". It assumes everyone on this board is a "less than desirable" type element which we know is patently untrue and paints a picture of the "well then let them die they brought it on themselves" attitude similar to the "gay bathhouses" of the 80s HIV.
That is the only point I was trying to make. It's an ANYONE disease but people do NOT see that whatsoever.
(PS Not to offend anyone yes I did drugs in the 80s and that might be where I got this, or from my xhusband who's had it for 25 years or from transfusions I've received. I dont know.)
People need to totally get over the "HOW" anyone got this disease and treat it more like the serious disease it is.
I sound very conspiracy theorist but I truly believe it does play a huge part in the social world and in the funding and everything like that.
I sound very conspiracy theorist but I truly believe it does play a huge part in the social world and in the funding and everything like that.
You both make good points-we need to know the "how" to educate, but we need to get people PAST the "how", so it can be dealt with properly.
Ain't that the truth.
BTW, I lived in fear of opening my mail for months, as my mail passed through the facilities that had the Anthrax contamination. There was mail I didn't get, and mail I didn't want. It was reported around here that the strain of Anthrax was thought/known to be you know where. I don't want to get the wrong debate started here, but this is for your eyes:
http://www.newsmax.com/archives/ic/2004/5/28/114140.shtml
Isn't that a whoot?
BTW, I lived in fear of opening my mail for months, as my mail passed through the facilities that had the Anthrax contamination. There was mail I didn't get, and mail I didn't want. It was reported around here that the strain of Anthrax was thought/known to be you know where. I don't want to get the wrong debate started here, but this is for your eyes:
http://www.newsmax.com/archives/ic/2004/5/28/114140.shtml
Isn't that a whoot?
Well said CTOAN. I think there can be a tendency towards hyperbole and dramatic language here, from many people, including myself. This is such a heated issue with many people's very lives at stake...that said, we can all find ways to state our points and/or opinions, disagreements, whatever, without resorting to insulting anybody if we just take care a little better care with our language.
None of us are "real" experts on this disease because there aren't any. Some of us are far more informed then others as laymen, but even the leading hepatologists, microbiologists, what have you...have so far only made good and bad calls on this disease.
For now they are just making a lot of educated guesses and propositions based on previous models and analyses that have worked or not worked for an x number of people, etc. While they are hopefully finding some concrete answers and better treatments we here are trying to sort our way through all the information...trying to do the best we can with the information we have here and now, sharing it and discussing it. To me the function of these boards is mostly information sharing and support, at least to my way of thinking. I always get a little uncomfortable with statements that indicate I'm totally right and youre totally wrong, who really knows for sure on many of these issues? A lot of this is still up in the air, more shall be revealed...and hopefully sooner than later.
Just 6 months or so ago I was speaking with one hepatologist who told me that Vertex 950 getting fast-tracked soon was nonsense (at least I didn't get the "I'm a Doctor, you are just a patient" condscending look...he was looking down at his notepad at the time) and that there wouldn't be any good alternative treatments to peg-combos for another 10 years. That was enough for me to seek another opinion....and that's what they are so far, opinions.
None of us are "real" experts on this disease because there aren't any. Some of us are far more informed then others as laymen, but even the leading hepatologists, microbiologists, what have you...have so far only made good and bad calls on this disease.
For now they are just making a lot of educated guesses and propositions based on previous models and analyses that have worked or not worked for an x number of people, etc. While they are hopefully finding some concrete answers and better treatments we here are trying to sort our way through all the information...trying to do the best we can with the information we have here and now, sharing it and discussing it. To me the function of these boards is mostly information sharing and support, at least to my way of thinking. I always get a little uncomfortable with statements that indicate I'm totally right and youre totally wrong, who really knows for sure on many of these issues? A lot of this is still up in the air, more shall be revealed...and hopefully sooner than later.
Just 6 months or so ago I was speaking with one hepatologist who told me that Vertex 950 getting fast-tracked soon was nonsense (at least I didn't get the "I'm a Doctor, you are just a patient" condscending look...he was looking down at his notepad at the time) and that there wouldn't be any good alternative treatments to peg-combos for another 10 years. That was enough for me to seek another opinion....and that's what they are so far, opinions.
I didn't eat a Big Mac but I DID have a hamburger...is it possible that some of the special sauce dripped on the bun by accident and I got infected? :-O
Couldn't Think
The most important thing of all of this is raising awareness on the possible ways of infection (Lord first I wrote contamination? What we are contaminiated? Talk about brain fog?)
People don't get it what so ever. I really have to admit before I got it I really DID think mostly that you had to use IVdrugs to be at a chance to get it. My xhusband had it since the early/mid 80s. I was always told it was practically impossible to get via sex and I didn't need to be tested.
If anyone told me THAT right now I would think it lunacy and be tested right away. ANY chance of getting it should be taken just as seriously as the next (of course IVDU being on top).
Honestly, I think there is a very good chance that I COULD have gotten it that way - statistics aside. A chance is a chance is a chance.
and people have to take them ALL seriously - not just one.
But first they need to know what they ARE. And they just do NOT.
Couldn't Think
The most important thing of all of this is raising awareness on the possible ways of infection (Lord first I wrote contamination? What we are contaminiated? Talk about brain fog?)
People don't get it what so ever. I really have to admit before I got it I really DID think mostly that you had to use IVdrugs to be at a chance to get it. My xhusband had it since the early/mid 80s. I was always told it was practically impossible to get via sex and I didn't need to be tested.
If anyone told me THAT right now I would think it lunacy and be tested right away. ANY chance of getting it should be taken just as seriously as the next (of course IVDU being on top).
Honestly, I think there is a very good chance that I COULD have gotten it that way - statistics aside. A chance is a chance is a chance.
and people have to take them ALL seriously - not just one.
But first they need to know what they ARE. And they just do NOT.
An excellent post.
Everything thing IS an opinion and I took look to these boards for information and assessement of it - and for support.
NOBODY know anything for SURE and nobody's opinion is more valid than the other. Otherwise.....we've seen what happens around here when feelings on our opinions get skewed. Lots of hurt feelings.
and a heppers feelings arleady seem to be hurt enough if you ask me.
I too am looking forward to Vertex as a strong POSSIBILITY of an easier more effective CURE but all it really is right now is a strong possibility (albeit one we are praying for with all our might).
I wanted to respond better to the combo treatment but am having problems right now...so I understand exactly how CTOAN feels. Hopefully this WILL work and then we won't have to hope for it any longer.
But until then - all our thoughts and opinions remain just that.
There are no doctors here ;-) (Although I think many of the people in here know more than my doctor for SURE!) :)
Everything thing IS an opinion and I took look to these boards for information and assessement of it - and for support.
NOBODY know anything for SURE and nobody's opinion is more valid than the other. Otherwise.....we've seen what happens around here when feelings on our opinions get skewed. Lots of hurt feelings.
and a heppers feelings arleady seem to be hurt enough if you ask me.
I too am looking forward to Vertex as a strong POSSIBILITY of an easier more effective CURE but all it really is right now is a strong possibility (albeit one we are praying for with all our might).
I wanted to respond better to the combo treatment but am having problems right now...so I understand exactly how CTOAN feels. Hopefully this WILL work and then we won't have to hope for it any longer.
But until then - all our thoughts and opinions remain just that.
There are no doctors here ;-) (Although I think many of the people in here know more than my doctor for SURE!) :)
hmmm, as a member of PETA I've rescued 16 dogs and 12 cats, put them in very nice homes and they are thriving...dont remember scarring anyone.
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