Category Archives: Hepatitis

A states obligated to provide expensive hepatitis C drugs?

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By Michael Ollove
Stateline

A handful of federal lawsuits against states that have denied highly effective but costly hepatitis C drugs to Medicaid patients and prisoners could cost states hundreds of millions of dollars.

The drugs boast cure rates of 95 percent or better, compared to 40 percent for previous treatments. But they cost between $83,000 and $95,000 for a single course of treatment.

The class actions, all filed in the last eight months in federal courts in Indiana, Massachusetts, Minnesota and Pennsylvania, present a series of extremes: a deadly epidemic, a treatment that can stop the disease in its tracks, and an enormous price tag.

At least 3.5 million Americans have hepatitis C, a virus spread through blood-to-blood contact that is usually contracted through the sharing of needles or other equipment to inject drugs.

Left untreated, hepatitis C slowly destroys the liver. Medicaid beneficiaries, a low-income population, have a slightly higher rate of hepatitis C infection than the privately insured, and the rate among prisoners is 30 times higher than in the general population.

The U.S. Food and Drug Administration approved the first of the new drugs, Sovaldi, in 2013. Since then, the FDA has also approved two other drugs, Viekira Pak and Harvoni.

But because the drugs are so expensive, state Medicaid programs and prisons have been restricting them to people in the advanced stages of the disease. Continue reading

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Insurers should be current on emerging treatments for consumers

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MKreidlerPhotoBy Mike Kreidler
Washington State Insurance Commissioner

A growing concern for consumers and health insurers is the cost of prescription drugs and specifically, treatment for debilitating and life-threatening diseases.

Hepatitis C is a good example. New drugs are now used to cure this life-threatening liver ailment with proven success. But the pills are costly, ranging from $55,000 to almost $95,000 per patient for a standard 12-week treatment period.

Two nationwide organizations, the American Association for the Study of Liver Diseases and the Infectious Disease Society of America, now recommend that most patients receive treatment even if they are in the early stage of the disease versus waiting until it has progressed.

Last November, the federal government encouraged states to ensure that health coverage policies are “informed” by the treatment guidelines noted above. Unfortunately we do not have the authority to mandate that insurance companies abide by the guidelines. However, we do expect insurers to be current on all appropriate guidelines that best serve consumers. That is true for all types of treatments.

We recently asked health insurers in Washington if they were aware of the new guidelines and if they were making any changes to how they were treating patients with this disease. The responses were varied, but there were common themes:   Continue reading

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Hep Saavy: All baby boomers should get screened for Hepatitis C

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Public Health – Seattle & King County

Are you a baby boomer born between 1945 and 1965, or have a family member who is? Read on to learn about an important new screening your health care provider will be offering their baby boomer patients.Hepatitis C by the numbers

Recent guidelines recommend that all baby boomers should be screened for Hep C. That’s right – all baby boomers

.Viral hepatitis is an alphabet soup of diseases, defined by liver inflammation and caused by different viruses (Hepatitis A, B, C, D, & E). Hep A, B, and C are the most common forms (click the links for more information and signs and symptoms):

  • Hep A: Typically spread through contaminated water or food, including fruits, vegetables and shellfish.  It may also be spread through close contact with an infectious person. Children are routinely vaccinated for Hep A. Hepatitis A does not cause chronic infections (long term or lifelong).
  • Hep B: Typically spread through contact with blood or body fluids on an infected person. A vaccine is available and is typically given at birth and with subsequent vaccination. Hepatitis B can cause chronic infection.
  • Hep C: Typically spread contact with the blood of an infected person, such as through intravenous drug use, non-sterile medical equipment, and blood transfusions before 1992 (blood is now screened to prevent Hep C transmission). Less commonly, a person can also get Hep C through sharing personal care items that may have come in contact with another person’s blood, such as razors or toothbrushes or having sex with a person infected with the Hep C.

Hep C causes a chronic infection in most people and often doesn’t show symptoms until the disease is well advanced. People with advanced Hep C can develop cirrhosis (liver scarring), cancer, upper gastrointestinal bleeding, and is the leading cause of liver cancer and liver transplants. There is no vaccine, but there are very effective new treatment options.

Recent guidelines recommend that all baby boomers should be screened for Hep C. That’s right – all baby boomers, even those who haven’t had a transfusion or don’t think they’ve had a known risk factor. Continue reading

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State’s disease outbreak preparedness falls short — report

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Washington Scored Five Out of 10 on Key Indicators Related to Preventing, Detecting, Diagnosing and Responding to Infectious Disease Outbreaks

MERS virus

A new report finds Washington state scored only 5 out of 10 on key indicators related to preventing, detecting, diagnosing and responding to outbreaks.

The state-by-state analysis was prepared by Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF)

Twenty-eight states and Washington, D.C. scored 5 or lower out of 10 key indicators.

Five states—Delaware, Kentucky, Maine, New York and Virginia—tied for the top score, achieving eight out of 10 indicators. Seven states — Idaho, Kansas, Michigan, Ohio, Oklahoma, Oregon and Utah — tied for the lowest score at three out of 10.

The report, Outbreaks: Protecting Americans from Infectious Diseases, concluded that the United States must redouble efforts to better protect Americans from new infectious disease threats such as MERS-CoV and antibiotic-resistant Superbugs and resurging illnesses like whooping cough, tuberculosis and gonorrhea. Continue reading

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Chipotle in South Lake Union closed for repeated food safety violations

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chipotleBy  
Public Health – Seattle & King County

Public Health – Seattle & King County’s Food Safety Program closed the Chipotle Mexican Grill at 212 Westlake Ave. N today for repeated food safety violations.

Last month, forty-three Chipotle restaurants in Washington and Oregon voluntarily closed their doors when they became linked with an E. Coli outbreak.

In order to re-open their facilities, restaurants were required to perform a top-down cleaning and sanitation, discard all produce, and pass an inspection by our health inspectors.

On November 1o, all seventeen King County Chipotle restaurants met criteria to reopen their doors.

In the time since, Public Health has continued to closely monitor Chipotle and has conducted inspections at all King County locations.

The South Lake Union restaurant closed today has received red violations on three consecutive visits, including the inspection today (its second inspection since the E. coli outbreak).

Red violations indicate improper practices or procedures identified as the most prevalent in contributing to foodborne illness.

In each one of these inspections, the total red violation points were between 25-33 points out of 400 possible points, well below the 90 point threshold for a closure.

However, because this location showed repeated violations, the health department closed the restaurant.

Public Health food program staff are working with Chipotle to correct these problems, and the restaurant will be allowed to re-open pending an inspection.

Chipotle inspection 1

Continue reading

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Medicaid denies nearly half of requests for hepatitis C drug

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Hepatitis C virus

Hepatitis C virus

By Michelle Andrews
KHN

People with hepatitis C who sought prescriptions for highly effective but pricey new drugs were significantly more likely to get turned down if they had Medicaid coverage than if they were insured by Medicare or private commercial policies, a recent study found.

Researchers at the University of Pennsylvania Perelman School of Medicine analyzed the hepatitis C prescriptions from 2,342 patients in Maryland, Delaware, Pennsylvania and New Jersey that were submitted between November 2014 and April 2015 to a large specialty pharmacy that serves the region.

The drugs included Sovaldi, Harvoni and Viekira Pak, and others that are part of the treatment regimen. A 12-week course of treatment for one patient can reach more than $90,000. Continue reading

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Can Yelp help track food poisoning outbreaks?

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yelp-logoBy Barbara Feder Ostrov
KHN

When a Shigella outbreak at a San Jose, Calif. seafood restaurant sickened dozens of people last weekend, Yelp reviewers were on the case – right alongside public health officials.

“PLEASE DO NOT EAT HERE!!!!” Pauline A. wrote in her Oct. 18 review of the Mariscos San Juan #3 restaurant. “My sister in and brother-in-law along with his parents ate here Friday night and all four of them ended up in the hospital with food poisoning!!!”

Research suggests that Yelp reviews may act as an early warning system or identify potential patients that public health officials might not otherwise have found in their food-borne illness investigations.

That same day, the Santa Clara County Public Health Department shut down the restaurant. Two days later, officials announced that more than 80 people who had eaten there had become acutely ill, with many requiring hospitalization. Twelve diners went to intensive care units.

Since then, the outbreak has grown to  more than 90 cases in Santa Clara and Santa Cruz counties. Continue reading

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Medicare spending for hepatitis C cures surges

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Twenty-dollar bill in a pill bottleBy Charles Ornstein ProPublica
This story was co-published with The Washington Post.

Medicare’s prescription drug program spent nearly $4.6 billion in the first half of this year on expensive new cures for the liver disease hepatitis C 2014 almost as much as it spent for all of 2014.

Medicare’s drug program spent an eye-popping $4.8 billion for hepatitis C drugs in 2014.

Rebates from pharmaceutical companies 2014 the amounts of which are confidential 2014 will reduce Medicare’s final tab for the drugs, by up to half. Even so, the program’s spending will likely continue to rise, in part because of strong demand.

Medicare’s stunning outlays, spelled out in data requested from the government by ProPublica, raise troubling questions about how the taxpayer-funded program can afford not only these pricey medications, but a slew of others coming on the market. Continue reading

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Parents in poor countries have worry about vaccines, too: If they can get them for their children

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Globe 125X125The Republican presidential debates have fueled another round of vaccine anxiety in the U.S. But in the world’s poorest countries, parents have a different set of concerns: They worry about getting their kids immunized quickly enough.

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Ouch! Vaccination rates for older adults falling short

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Vaccine SquareBy Phil Galewitz
KHN

Three out of four Americans older than 60 don’t get a shingles vaccine to protect themselves from the virus’ miseries: rashes over the face and body, stinging pain that can last for weeks or months and the threat of blindness.

Sometimes people must feel a pound of pain – someone else’s – to take a shot of prevention. Dr. Robert Wergin tells of one elderly patient with shingles who came to his Milford, Neb., office this summer. “I’m sorry, doc, I should have listened to your advice to get the shot,” the man said. A few weeks later, the man’s wife and brother, both in their 60s, visited Wergin, asking for the vaccine.

One in three seniors each year skips the flu vaccine.
Four in 10 seniors are not vaccinated for pneumonia.
Nearly half of seniors are not immunized for tetanus

“It’s amazing how once people see the disease up close, getting the vaccine suddenly raises up on their list of priorities,” said Wergin, president of the American Academy of Family Physicians.

The shingles vaccine is not the only shot that public health officials are struggling to persuade older Americans to get. Continue reading

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Vaccine rates leave many Washington toddlers at risk

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Alert IconFrom Washington State Department of Health

New immunization rates show many toddlers across the state aren’t getting vaccinated for certain diseases on time, if at all, according to the Centers for Disease Control and Prevention’s (CDC) National Immunization Survey.

The trend means more children are at risk of getting measles, whooping cough, or other preventable diseases.

The trend means more children are at risk of getting measles, whooping cough, or other preventable diseases.

The annual survey reports that children between 19 and 35 months of age weren’t any more protected against serious and potentially fatal diseases than the year before. About 67 percent of toddlers in 2014 were fully vaccinated by 3 years of age.

This overall rate is about 3 percent lower than 2013, but statistically the two rates are not significantly different.Washington’s immunization rates for 2014 did not improve for most recommended vaccines for young children.

The lone exception was the dose of hepatitis B vaccine given at birth. Coverage rates for the hepatitis B birth dose vaccine exceeded national coverage rates, increasing to almost 80 percent.

“The data show that we’re not protecting all of our kids as well as we should,” said State Health Officer Dr. Kathy Lofy. “We’re disappointed that our rates aren’t higher. When kids aren’t fully protected, it puts those kids and the wider community at risk of disease. The recent spike in measles cases and the ongoing whooping cough outbreak highlights the need for high vaccination rates.” Continue reading

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Seattle Children’s discovers lapse in sterilization at Bellevue clinic | Patients may need to be tested for Hep. B, C, HIV – Bellevue Reporter

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Seattle Children's Whale LogoSeattle Children’s Hospital is working with the state health department and the Centers for Disease Control after it was revealed that the required procedures for cleaning and sterilizing surgical instruments at the hospital’s Bellevue Clinic and Surgery Center were not always followed.

“I understand that families will be concerned, and rightly so, but from a scientific perspective, the risk is low, which I hope that families find reassuring,’ Seattle and King County Public Health official Justin Duchin, M.D. said at a press conference on August 26.

As a result of the problems with sterilization, patients who had a surgical procedure at the Bellevue Clinic may need to be tested for hepatitis B and C, as well as HIV, the hospital said in a statement.

Source: Seattle Children’s discovers lapse in sterilization at Bellevue clinic | Patients may need to be tested for Hep. B, C, HIV – Bellevue Reporter

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