Friday, June 24, 2011

Not Again! The Itching is Back

About a week ago the palms of my hands began itching. My family and I were on a week-long roadtrip and I assumed it was due to the hotel laundry soap or lotion, perhaps a plant I had touched - who knows? But after a couple of days the itching spread and worsened and when I had bloodwork done this week, the mystery was solved: My bilirubin is high and I'm experiencing pruritus.

I struggled with this four months ago. Fortunately, after a few weeks my bilirubin level decreased (and finally fell into normal range) and the itching went away... until now.

There are few things more frustrating than non-stop itching. I have spots on my body that are red and irritated from scratching and I'm starting to get a bit grumpy. Ugh! I'm having hernia surgery in four days and can't imagine the combined pain-itching experience afterward. This could be interesting... and not in a good way.

Photo by SuperFantastic

Wednesday, June 8, 2011

Saving Your Liver May Cost an Arm and a Leg

As noted in my most recent post, the FDA has just approved two new medications to treat Hepatitis C: Incivek (Vertex's telaprevir)and Victrelis (Merck's boceprevir). According to, Dr. Douglas Dieterich, a professor of medicine in the division of liver diseases, at Mount Sinai School of Medicine in New York City, said that the approval of Incivek and Victrelis "represent the first real advances in the treatment of hepatitis C in 13 years."

This advancement is the best news Hep C patients have received in years - but celebrations may be premature. The astronomical costs of these meds could be an overwhelming barrier to treatment.

A May 25, 2011 post on the HBV and HCV Advocate Blog featured the Fair Pricing Coalition's stance on the price set for Incivek:
...the Fair Pricing Coalition (FPC) is appalled at the price set by Vertex for Incivek,” said FPC member Lynda Dee. “The FPC is concerned that the exorbitant wholesale acquisition cost (WAC) of $49,200 per 12 week course of Incivek treatment will adversely affect the ability of people with HCV to access this new drug and that it will also set an excessively unreasonable future price point for the many HCV drugs in the pipeline.

“Merck’s Victrelis costs $48,400 for 48 weeks of treatment. Now Vertex has set a price approximately four times greater than Victrelis for twelve weeks of Incivek treatment. While we welcome a shorter course of Incivek treatment, both price points are outrageous.

The FDA label recommends that 12 weeks of Incivek be taken with pegylated interferon and ribavirin for either 24 or 48 weeks, depending on a patient’s response to the regimen. The WAC price for 48 weeks of HCV treatment with pegylated interferon and ribavirin is approximately $30,000. The $49,200 WAC price for 12 weeks of Incivek will more than double the already exorbitant 48 week price of pegylated interferon and ribavirin.

The FPC also cites an expected "...30% increase in the cost of treating side effects caused by use of the new HCV protease inhibitor drugs."
More information is available in the story and at

Just last night I watched a television news show about the high quality, low cost health care available in Thailand, where hospitals are actively working to attract patients from other countries, including the US. My heptologist traveled there earlier this year and also commented on how good the health care is. Maybe we should move?

Photo by Marc Garrido i Puig