Category Archives: Hepatitis

Are vaccinations ‘Everybody’s Business’? – documentary and discussion

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A community conversation sponsored by the Northwest Biomedical Research Association

Are Vaccinations ‘Everybody’s Business?’

Discussion of the locally-made documentary, “Everybody’s Business,” by Laura Green, which examines the small, tight-knit community of Vashon Island that has become a reluctant poster child for the growing debate around childhood vaccinations. This portrait of an island community digs beneath the surface to investigate the tensions between individual choices and collective responsibilities.

Tuesday night’s conversation will be facilitated by Dr. Doug Opel, Seattle Children’s Research Institute.

WHEN:
Tuesday
December 9, 2014
From 5:45pm to 7:45pm

WHERE:
Macao Chocolate+Coffee
415 Westlake Ave N.
Seattle, WA 98109

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Hepatitis C patients may not qualify for pricey drugs unless illness is advanced

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Twenty-dollar bill in a pill bottleBy Michelle Andrews
KHN / October 28, 2014

In the past year, new hepatitis C drugs that promise higher cure rates and fewer side effects have given hope to millions who are living with the disease.

But many patients whose livers aren’t yet significantly damaged by the viral infection face a vexing reality: They’re not sick enough to qualify for the drugs that could prevent them from getting sicker.

An estimated 3 million people have hepatitis C. Faced with a cost per patient of roughly $95,000 or more for a 12-week course of treatment, many public and private insurers are restricting access to those who already have serious liver damage.

Many baby boomers who have hepatitis C contracted it years ago from blood transfusions at a time when blood was not screened for the virus.

Other strategies that limit access include restricting who can prescribe the drugs or requiring early proof the drug is working before continuing with treatment.

In addition, many state Medicaid programs require that patients be drug and alcohol free for a period of months before they can get the hepatitis C drugs. Continue reading

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Even before Ebola, hospitals struggled to beat far more common infections

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Clostridium difficile

Clostridium difficile

This KHN story also ran on NPR.

While Ebola stokes public anxiety, more than one in six hospitals — including some top medical centers — are having trouble stamping out less exotic but sometimes deadly infections, federal records show.

Nationally, about one in every 25 hospitalized patients gets an infection, and 75,000 people die each year from them—more than from car crashes and gun shots combined.

Nationally, about one in every 25 hospitalized patients gets an infection, and 75,000 people die from them each year.

 from themA Kaiser Health News analysis found 695 hospitals with higher than expected rates for at least one of the six types of infections tracked by the federal Centers for Disease Control and Prevention.

In 13 states and the District of Columbia, a quarter or more of hospitals that the government evaluated were rated worse than national benchmarks the CDC set in at least one infection category, the KHN analysis found.

The missteps Texas Health Presbyterian Hospital made this month in handling an Ebola patient echo mistakes hospitals across the nation have made in dealing with homegrown infections. Continue reading

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Vaccination rates lower among US adults born abroad

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Vaccine SquareBy Milly Dawson
Health Behavior News Service

Nationality at birth appears to play a significant role in whether or not adults in the United States are routinely vaccinated for preventable diseases, a new study in the American Journal of Preventive Medicine finds, reflecting a risky medical lapse for more than one in ten people nationwide.

Foreign-born adult U.S. residents, who make up about 13 percent of the population, receive vaccinations at significantly lower rates than U.S.-born adults.

Foreign-born adult U.S. residents make up about 13 percent of the population.

This gap poses special risks for certain groups of people who are vulnerable to many serious and sometimes deadly diseases that vaccines can prevent.

The study’s lead author, Peng-Jun Lu, MD, PhD, a researcher at the Center for Disease Control and Prevention, noted the rise in the foreign-born population in the United States, which stood at only five percent in 1970.

“As their numbers continue to rise, it will become increasingly important to consider this group in our efforts to increase vaccination and eliminate coverage disparities,” he said. Continue reading

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States negotiate for better drug prices

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Because of skyrocketing prescription drug prices, some state Medicaid programs and prison systems are limiting certain drugs to only the sickest patients. Some states are negotiating better pricing.

By Michael Ollove
Stateline

Twenty-dollar bill in medicine bottleThe new hepatitis C drug Sovaldi promises a cure rate of well over 90 percent, compared to 45 percent (at best) for older drugs. But when Sovaldi went on the market earlier this year for as much as $84,000 for a single course of treatment, critics blasted the cost as “exorbitant” and “gouging.”

It is estimated that between 3.2 million and 5.2 million Americans have hepatitis C, an infectious illness that can eventually compromise the liver.

The disease falls disproportionately on the poor and the incarcerated, which makes it a particular challenge for Medicaid, the federal-state health plan for the poor, and for state prison systems.

One study by Express Scripts, a drug benefits management company, estimated it would cost states $55 billion to provide Sovaldi to all prisoners and Medicaid beneficiaries with hepatitis C.

Because of its high cost, some state Medicaid programs and prison systems are refusing to provide Sovaldi to any but the sickest patients. Most recently, Oregon last month threatened to limit access to the drug unless it can get Sovaldi at a deeply discounted price.

“Sovaldi is a seminal event,” said Matt Salo, executive director of the National Association of Medicaid Directors. “It’s clear that states are not equipped to handle this. They simply do not have the tools to maintain control.”

But Sovaldi is only the beginning. Expensive new treatments for certain cancers, rheumatoid arthritis and other conditions also have rattled Medicaid officials, patients and health care providers.

What can states do to hold down drug costs? Drug pricing is a complicated and opaque process. Here are some of the basics.

Question: Is each state Medicaid program on its own when it comes to drug pricing?

Answer: Not completely. The federal Omnibus Budget Reconciliation Act of 1990 mandates that drug makers give all Medicaid programs a 23 percent rebate off the Average Manufacturers Price (AMP) for all prescription drugs purchased, or the difference between the AMP and the best price given to a private payer. (Prisons aren’t covered by this discount provision and have to negotiate drug prices as any retailer does.)

In return for the rebates, Medicaid programs must carry all drugs approved by the U.S. Food and Drug Administration on their “formularies,” which is the list of the medications each health plan will pay for.  That guarantee means that the drug makers get access to substantial markets in all 50 states and the District of Columbia. Continue reading

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County receives $6m grant to improve hepatitis C care

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Hepatitis C by the numbersKing County has received a four-year, $6 million grant to improve testing, treatment and cure rates of people with chronic HCV infection.

Hepatitis C virus (HCV) affects large numbers of people in King County, but it often goes unnoticed until it’s too late.

“Thousands of people in King County have chronic HCV, but many don’t know they have it,” said Dr. Jeff Duchin, Chief of Communicable Disease & Epidemiology at Public Health – Seattle & King County. “This grant will allow us to make sure that patients with chronic HCV are not just identified, but also seen by a provider, receive follow-up testing, and get the care they need.”

The grant will fund the Hepatitis C Test & Cure Project, which will provide training for clinicians on the diagnosis, evaluation, and treatment of HCV and connect them to specialists. Continue reading

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Immunization rates for Washington kids improve over last year

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From the Washington State Department of Health

child wincing while be given a shot injectionImmunization rates for Washington toddlers have improved from last year, according to the latest Centers for Disease Control and Prevention (CDC) National Immunization Survey.

The survey says 71 percent of kids under three years old in Washington got a series of recommended vaccines in 2013.

The state’s rate for the same series of vaccines in 2012 was 65 percent.

Pertussis vaccination still low and concerning in light of recent epidemic

Although rates have improved, they’re still below the Healthy People 2020 goal of 80 percent, leaving many kids unprotected.

For all vaccines counted, rates increased across the board except for DTaP, the vaccine that prevents pertussis (whooping cough).

This is especially concerning because of our state’s whooping cough epidemic in 2012. Continue reading

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New shellfish safety map shows risks in real-time

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From the Washington State Department of Health

shellfish mapA new online shellfish safety map gives shellfish harvesters an up-to-date look at biotoxins, pollution, and bacteria levels at public beaches or on their private property.

Beach names, nearby landmarks, and specific addresses are searchable to help provide real-time information on shellfish safety risks.

The new shellfish safety map was developed to provide current information about areas where water quality conditions and public health risks are evaluated by the Department of Health. Continue reading

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New hepatitis C treatments – FDA Consumer Update

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fda-logo-thumbnailFrom the US Food and Drug Administration

At the approval of several new drugs for hepatitis C is  welcome news for baby boomers—who make up three of four adults with the hepatitis C virus—and millions of other Americans, many of whom don’t yet know they are infected and carriers, says the US Food and Drug Administration in this Consumer Update.

Hepatitis C can be cured, and today’s drug therapies are very effective and easier for patients to take, says Jeffrey S. Murray, M.D., the deputy director of the Division of Antiviral Products in FDA’s Center for Drug Evaluation and Research. Murray is an internist who specializes in infectious diseases.

A Preventable and Curable Disease

Continue reading

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Grilling tips from the Department of Health

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State officials advise: be known for great grilling, not making people sick

Photo by Michal Zacharzewski

Photo by Michal Zacharzewski

Food safety experts from the Department of Health want people to know how to protect themselves and their loved ones from foodborne illnesses, especially when preparing foods for picnics and barbecues during warm weather.

“Bacteria in or on food can multiply quickly in warm weather,” explains State Health Officer Dr. Kathy Lofy. “By making sure food is prepared, cooked, and served properly you can reduce the risk of foodborne illnesses and be well-known for great barbecues and picnics instead of for making people sick.”

Safeguards can be taken when preparing foods to be eaten outdoors, such as using a food thermometer to make sure that meat and poultry are cooked at the correct temperature. Continue reading

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Know your hepatitis ABCs for Hepatitis Awareness Month – CDC

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From the US Centers for Disease Control and Prevention

Graphic: Millions of Americans are living with viral hepatitis.

  • Hepatitis A: Outbreaks in the US do occur.
  • Hepatitis B: Asian Americans and Pacific Islanders have higher rates.
  • Hepatitis C: New treatments can cure the disease.

Viral hepatitis is a major global health threat and affects over 4.4 million Americans. In observance of May as Hepatitis Awareness Month, here are brief overviews of each of the three most common types of viral hepatitis in the United States: Hepatitis A, Hepatitis B and Hepatitis C.

Hepatitis A: Outbreaks in the US can and do occur

Continue reading

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Q: Are insurers required to cover HIV prevention medication Truvada?

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Q. Now that the federal Centers for Disease Control and Prevention recommends a daily pill to prevent infection with the virus that causes AIDS, will my insurer be required to cover the drug at no cost to me?

A. No, it won’t be required, not at this time. Earlier this month the CDC released new clinical guidelines recommending that people who are at substantial risk of becoming infected with HIV, the virus that causes AIDS, take a daily pill called Truvada. This “pre-exposure prophylaxis” approach can prevent HIV infection in more than 90 percent of cases. Continue reading

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National strategy needed to eliminate hepatitis C

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Hepatitis CBy Michael Ollove
Stateline Staff Writer
May 19, 2014

The U.S. is in the midst of a hepatitis C epidemic with as many as 3.9 million Americans infected with the liver-damaging virus.

Aggressively targeting a concentrated population with the contagious but curable disease could be the best approach to eradicating the deadly virus.

The most logical place to launch the counterattack is in the country’s jails and prisons, where the infection rate is about 17 percent, compared to 1 percent to 2 percent overall in the U.S., said Josiah Rich, a Brown University infectious disease physician.

A recent study estimated that 1.86 million people with the virus were incarcerated.

“With more than 10 million Americans cycling in and out of prisons and jails each year, including nearly one of every three HCV (hepatitis C)-infected people,” Rich said, “the criminal justice system may be the best place to efficiently identify and cure the greatest number of HCV-infected people.” Continue reading

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Medicare struggling with high-cost hepatitis-C drugs

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Walter Bianco, 65, at his Arizona home, has had hepatitis-C for more than 40 years. (Photo by Alexandra Olgin/KHN)

Walter Bianco, 65, at his Arizona home, has had hepatitis-C for more than 40 years. (Photo by Alexandra Olgin/KHN)

By Richard Knox
MAY 12, 2014

This KHN story was produced in collaboration with NPR

Walter Bianco has had hepatitis-C for 40 years, and his time is running out.

“The liver is at the stage next to becoming cirrhotic,” the 65-year-old Arizona contractor says. Cirrhosis is severe scarring, whether from alcoholism or a chronic viral infection. It’s a fateful step closer to liver failure or liver cancer.

If he develops one of these complications, the only possible solution would be a hard-to-get liver transplant. “The alternative,” Bianco says, “is death.”

Previous drug treatments didn’t clear the virus from Bianco’s system. But it’s almost certain that potent new drugs for hep-C could cure him.

However, the private insurer that handles his medication coverage for the federal Medicare program has twice refused to pay for the drugs his doctor has prescribed.

Doctors are seeing more and more patients approaching the end-stage of hep-C infection. “There isn’t day that goes by when I don’t have a story very similar to Mr. Bianco’s,” says Dr. Hugo Vargas of Mayo Clinic in Scottsdale, AZ, his liver specialist. Continue reading

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Who should get pricey hepatitis C drugs?

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 This KHN story was produced in collaboration with wapo

Simple math illustrates the challenge facing U.S. taxpayers, consumers and insurers following the launch late last year of two expensive new drugs to treat hepatitis C.

If all 3 million people estimated to be infected with the virus in America are treated at an average cost of $100,000 each, the amount the U.S. spends on prescription drugs would double, from about $300 billion in one year to more than $600 billion.

That prospect has inspired an unusually blunt public debate:  Should expensive treatments – one new drug costs $1,000 a pill — be limited only to the sickest patients, or is it appropriate to treat all who want the drugs immediately? And should those in taxpayer-funded programs have the same access? Continue reading

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