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Britain Has No Problem Paying for
Expensive Hepatitis C Drugs/Different Healthcare Systems
  New Models for Healthcare Funding Needed - (08/06/14)
from Jules: it is time to discuss a new model for evaluating new life-saving medical treatments. The federal govt spends $22 bill a year on HIV, $4.5 bill in medicare, $5 bill a year in medicaid, in perpetuity, that means after 30 years on ARTs it cost $500,000 in just drug costs & more on care (doctor visits etc), but medicaid & commercial payers do not complain. The current cost for Sovaldi reflects a 24% discount for medicaid & 44% for the VA, and so far this year only 70,000 people throughout the USA have been treated with Sovaldi, which is much less then medicaid's projected in the early part of this year, why, because they mounted a PR campaign to convince the public that is was a budget buster. The first year when telaprevir & boceprevir were launched only 100,000 people were treated. The system can only process so many people, the medicaid's intentionally hyper-inflated their projections of the number of patients as part of their PR campaign, and here is a report from Mt Sinai Hospital in NYC on the costs of treatment with telaprevir or Peg/Rbv. One difference between HIV & HV is that the HCV costs are all upfront so the cost, whatever it is 60/70 or 80k is all upfront while with HIV ART its $14k a year but its in perpetuity forever, so after 30 years on HAART as I said its $500,000. The healthcare system is set up to address ongoing medical costs for chronic diseases, it is not set up to address a one-time upfront cost for a cure, which is what Sovaldi is, the first time in history that we can cure a virus with a limited duration of therapy, in this case 12 weeks, its nevrr been done before. Medicaid & healthcare budgets are set up on an annual basis to address costs for that year so we need to discuss a new model to evaluate & pay for unique healthcare & new types of treatments. Public payers should not be able to deny access to life-saving treatment, in this case life-saving 12-weeks, no side effects, that we all agree in the end is cost-effective & will save lots of healthcare costs in the long run, this is a discussion that we need to begin to have on a federal level. Other subjects divert us from this discussion, we should focus like a laser on this and that medicaid denial to access with their newly devised restrictions appears illegal. The federal govt needs to step in, we need to get the federal govt to step in.
AASLD: Costs of Telaprevir-based Triple Therapy Including Adverse Event Management at the Mount Sinai Medical Center, NY $189,000 per SVR - (12/02/13)
Britain Has No Problem Paying for Expensive Hepatitis C Drugs
By John Tozzi August 18, 2014
Sovaldi, a highly effective treatment for the liver disease hepatitis C, has faced backlash in the U.S. over its price tag: $84,000 for a three-month course of treatment, or about $1,000 a pill. The private insurance industry has pushed back hard on the price. State Medicaid directors have said they are concerned about the cost, and paying for the drug is also problematic for prison systems, which must provide health for a lot of inmates who acquired hepatitis C by sharing needles.
Meanwhile, in the U.K., regulators just approved the use of Sovaldi as part of treatment for hepatitis C. The country's National Health Service will pay about $700 a pill, roughly what some Medicaid programs will pay in the U.S. The U.K.'s decision to recommend Sovaldi was far from a sure thing. But once the National Institute for Health and Care Excellence was convinced that Sovaldi is cost-effective, the decision to pay for it is simple, because one entity pays for all the medical care in the U.K. If treating a patient with costly drugs now prevents a more expensive liver transplant in 15 years, that savings accrues to the National Health Service-and ultimately to British taxpayers.
That's not the case in the U.S., where health care is paid for by a mix of employers, private insurers, and government programs such as Medicaid and Medicare. Hepatitis C can take 20 to 30 years to cause liver scarring that might require a transplant. An insurer paying for Sovaldi now is probably preventing an expensive treatment that would have ultimately been paid for by another part of the health-care system-most likely Medicare, the federal insurance program for Americans 65 and older. Insurers don't have much incentive to do that, even if it would save the U.S. health system money in the long run.
It's still fair to question how drugmaker Gilead Sciences (GILD) came up with the price for Sovaldi, and why it will sell an entire course of treatment in Egypt for less than the price of one pill in the U.S. And treatment of Sovaldi isn't the final verdict on whether a single-payer health-care system is better on the merits than the patchwork of private and public insurance programs the U.S. has. But Americans sometimes accuse Britain's single-payer system of rationing of health care. In the case of a cure for hepatitis C, it seems the single-payer model is doing the opposite.
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