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Why 88% of US military veterans with HCV are not treated
Journal of Hepatology
Volume 57, Issue 4 , Page 924, October 2012
To the Editor:
The article in the February issue of the Journal of Hepatology reported that less than 12% of American military veterans identified with HCV were treated with antiviral therapy [1]. The Veterans Administration does not want to spend adequate funds to cure patients with hepatitis C. Dr. Kenneth Kizer, Under Secretary for Health in the US Department of Veterans Affairs (VA), gave HCV a high priority but unfortunately he left the VA in 1999. Subsequent leadership has not shown enthusiasm for treating HCV.
The Director of Pharmacy and the Chief of Staff at my local VA hospital told me that I spent too much money treating HCV. Boceprevir and telaprevir are both on the hospital formulary but telaprevir prescriptions are routinely denied because it is more expensive. Patients must jump multiple hurdles before qualifying for antiviral therapy. No one would refuse to give coronary artery stents or bypass grafts to a veteran who smokes but veterans who do not completely abstain from alcohol for three months are refused antiviral therapy. In spite of difficulties, 585 of 1372 (43%) HCV RNA positive patients received antiviral therapy between 1998 and 2010 at our local VA hospital; 226 of 583 treated (39%) achieved SVR [2]. 36% of deaths were from HCC or liver failure. Veterans with sustained viral response had substantially improved survival. Effective antiviral therapy improves prognosis [3], [4]. Less than 2% of Americans die from liver disease, but more than one third of veterans with HCV die prematurely from complications of cirrhosis [2], [5]. According to a 2010 national VA report, deaths in veterans with HCV have more than tripled, “Between 2000 and 2008, the annual number of all cause deaths recorded for Veterans with chronic HCV rose from 1259 (1129 per 100,000 in VHA care) to 5967 (4049 per 100,000 in VHA care), respectively” [6].
Legislation should be passed allowing veterans with HCV to prequalify for their choice of Medicaid or Medicare so that they can obtain antiviral therapy in the private sector. Since Dr. Kizer is no longer in charge of the VA, it is very clear that the VA is not going to treat very many of them.
http://hepatitiscresearchandnewsupdates.blogspot.com/2012/09/why-88-of-us-military-veterans-with-hcv.html#.UFdtOa7O889
Volume 57, Issue 4 , Page 924, October 2012
To the Editor:
The article in the February issue of the Journal of Hepatology reported that less than 12% of American military veterans identified with HCV were treated with antiviral therapy [1]. The Veterans Administration does not want to spend adequate funds to cure patients with hepatitis C. Dr. Kenneth Kizer, Under Secretary for Health in the US Department of Veterans Affairs (VA), gave HCV a high priority but unfortunately he left the VA in 1999. Subsequent leadership has not shown enthusiasm for treating HCV.
The Director of Pharmacy and the Chief of Staff at my local VA hospital told me that I spent too much money treating HCV. Boceprevir and telaprevir are both on the hospital formulary but telaprevir prescriptions are routinely denied because it is more expensive. Patients must jump multiple hurdles before qualifying for antiviral therapy. No one would refuse to give coronary artery stents or bypass grafts to a veteran who smokes but veterans who do not completely abstain from alcohol for three months are refused antiviral therapy. In spite of difficulties, 585 of 1372 (43%) HCV RNA positive patients received antiviral therapy between 1998 and 2010 at our local VA hospital; 226 of 583 treated (39%) achieved SVR [2]. 36% of deaths were from HCC or liver failure. Veterans with sustained viral response had substantially improved survival. Effective antiviral therapy improves prognosis [3], [4]. Less than 2% of Americans die from liver disease, but more than one third of veterans with HCV die prematurely from complications of cirrhosis [2], [5]. According to a 2010 national VA report, deaths in veterans with HCV have more than tripled, “Between 2000 and 2008, the annual number of all cause deaths recorded for Veterans with chronic HCV rose from 1259 (1129 per 100,000 in VHA care) to 5967 (4049 per 100,000 in VHA care), respectively” [6].
Legislation should be passed allowing veterans with HCV to prequalify for their choice of Medicaid or Medicare so that they can obtain antiviral therapy in the private sector. Since Dr. Kizer is no longer in charge of the VA, it is very clear that the VA is not going to treat very many of them.
http://hepatitiscresearchandnewsupdates.blogspot.com/2012/09/why-88-of-us-military-veterans-with-hcv.html#.UFdtOa7O889
Sorry I'm on my phone I get this is a letter to the editor but
I can't tell who wrote the letter.
This is such a shame. Even the solutions he suggests is
grim. Pre-qualifying for Medicaid is not a position I would
want to be in just to treat the virus. I felt horrible when one guy on
here who was fortunate to some how treat under the VA and had no
access to Procrit and was on such a low dose of RIBA.
I can't tell who wrote the letter.
This is such a shame. Even the solutions he suggests is
grim. Pre-qualifying for Medicaid is not a position I would
want to be in just to treat the virus. I felt horrible when one guy on
here who was fortunate to some how treat under the VA and had no
access to Procrit and was on such a low dose of RIBA.
the us government should take care of our vets. it's the very least they should do for a group that allows our freedom. what a bunch of ******. that was my late father's pet peeve. thanks for sharing these facts. best wishes. belle
The fact that vets are more likely statistically to have hep C and that so many of them got it from those airjet gun inoculations, makes it that much more horrendous. The VA owes it to these guys to take care of them.
I used to be shocked when I heard about facts like this, but now I have learned not to be surprised. Shame on the VA for not treating 100% of the Vets, who request to be treated
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