Nhamba yepamusoro yezvokudenga zvechirwere chemaHepatitis C yave ichivhundutsa, uye zvechokwadi inonyadzisa kune avo vangave vakatarisana nepamusoro pehomwe co-pay, kana kuti yakaipisisa, yakaramba kuparidzirwa. Izvi zvinokumbirisa mubvunzo wakajeka: sei mishonga iyi inoponesa upenyu inodhura? Zvakakosha kusimbisa mberi kuti mishonga iyi inoponesa upenyu .
Dzinodzivirira kenza yeropa, kudzivisa kufambira mberi kune cirrhosis, uye inogona kudzivisa kufa kana kudiwa kwechiropa chekupemha.
Ngatitangei pakutanga uye tsvaga nzira yedu kusvika panguva ino. Muna 2010, interferon uye ribavirin ndivo maitiro ehutachiona hwehepatitis C. Nekusawirirana kunowanzoitwa (genotype 1), kubudirira kwaive kwakapoteredza 50 muzana, uye kunyange izvi zvakauya zvakakosha mari maererano nezviitiko zvakashata, nguva yekurapa (Mwedzi 6-12), uye mutengo wemari ($ 50,000- $ 70,000) uchifunga nezvekuongorora kwekuongorora ropa nekushanyira mahofisi kunoda panguva iyoyo.
Muna 2011, mavhiri ekutanga-maitiro, antiviral agents ( DAA s) akagamuchirwa (telaprevir uye boceprevir), iyo yakavandudza kubudirira kusvika makumi manomwe kubva muzana asi yakadawo kutarisirwa pamwe chete ne interferon uye ribavirin. Izvo zvakasvibiswa nemigumisiro yemishonga iyi inogumira kushingaira pasinei nehuwandu hwekubudirira huwandu uye mari yakakwirira.
Varwere vaida chirwere chakanga chisina michina ye interferon, yenguva pfupi uye nehutano hwepamusoro.
Kubva muna 2016, vazhinji kunyange vashandi vatsva vakabvumidzwa neDFA nehupfumi huwandu hunowedzera kusvika 90 muzana inoporesa kana yakakwirira nemigumisiro shoma. Muna 2013, wekutanga wevashandi ava vatsva vakasvika (sofosbuvir [Sovaldi] uye simeprevir [Olysio] ).
Mutengo wematongerwo evanhu vazhinji ava maitiro akaenzana, uye vamwe vanodhura $ 1000- $ 1200 pamapiritsi kubva muna 2016. Piritsi! Chirwere chemaawa gumi nemaviri-chegumi chinogona kukwana pakati pe $ 86,000- $ 94,000-kwete kusanganisira chiremba kushanyira kana kuongorora. Vashomanana vanogona kutenga mabhizimisi aya pasina rubatsiro rwakakosha yveshuwarensi
Saka Ndiani Anosarudza Tag Tag?
Mhinduro shomanana ndeyokuti kambani yemishonga yakagadzira chigadzirwa ichi inotara mutengo. Iyi ndiyo yekutengesa mari yakawanda (WAC). Havasungirwi kupa ruramisiro. Pane, zvisinei, zvimwe zvikonzero zvinofanirwa kufunga nezvazvo. Zvinodhura, pamavhareji, $ 2.6 mabhiriyoni uye zvinotora makore gumi kuti chirwere chisvike kugamuchira FDA, uye zvinenge zviviri kubva kune gumi zvinotengeswa zvinodhaka zvinowana zvakakwana kuti zvikwanise kubhadhara mari dzavo, zvichienderana nekuongorora kubva kuTufts University. Ma Pharmacy anobatsira vatungamiri (PBMs) uye Veteran's Affairs vanogona-uye vakataurirana zvikwereti kusvika 46 muzana kana kupfuura mune dzimwe nguva. Izvi zvinonyatsobatsira, asi Medicare inorambidzwa zviri pamutemo kutaurirana uye kubhadhara mutengo wakakwana. Sezvo inenge 70 muzana yevarwere vane hepatitis C muUnited States "vana bhoomers" vakaberekwa pakati pa1945 na1955, Medicare inova mukuru wehutano.
Saka, kana chirongwa chinoda mushonga wokubhadhara mushonga wemapato makumi maviri, izvo zvingaita sezviri kunyanya kuwedzerwa nekuda kwemishonga yeropa, izvi zvinogona kuva madhora madhora makumi maviri nemazana makumi maviri nemakumi maviri (12) kwemavhiki 12 ehepatitis C therapy. Uye kaviri iyo kana masvondo makumi maviri nemasere akasarudzwa.
Zvakakosha Here?
Kuvhiringidzika kwemiti yemishonga mitsva kwakaita kuti vakawanda vasave kana zvipatara zvakabhadhara mari. Chokutanga, kurapwa uku kunobatanidza ne "high" chirwere chepamusoro pamusoro pe 90 muzana. Kurapa kwechiitiko che hepatitis C kunobatsira zvikuru kurarama kwenguva refu uye hupenyu hwehupenyu. Haisi kungova nekuderera kwe "zvose-zvinokonzerwa nekufa", asi kunewo kuderedza kunoratidzika mune zvakanyanya kudiwa kwechiropa kupera uye kukura kwekenza yeropa.
Vaya vasina chirwere chepirrhosis panguva yekurapa vanogona kutarisira zvikuru sehupenyu huripo sezvavanenge vasina hupatitis C. Kutaura chokwadi, chimwe chezvikonzero zvekodzero yakawanda nemishonga yemishonga ndeyekuchengetedza kwepasi kunoda kudiwa chiropa chinoputika.
Ndezvipi zvimwe zvatinokwanisa kuongorora kukosha? Iko kune nzira dzakasiyana siyana dzakadzidzwa. Imwe nzira iri nyore ndeyokuverenga mari yekurapa nemishonga yemazuva ano zvichienzaniswa nemitemo yekare. Somuenzaniso, kana chirwere chakare chakanga chisingadhuri asi chinongoporesa 50 muzana yevarwere vanobatwa, mari yekurapa 100 muzana yevarwere vanogona kuita kuti izvi zviwedzere mari kune vanhu kunze kwemishonga inodhura zvakadhura yakaporesa 95 muzana. Izvi zvakaratidza pachena kuti ndizvo. Zvirwere zvekare zvakabatanidza peginterferon, ribavirin uye telaprevir yeboceprevir (muyero werapi yekurapa muna 2011), yaive pakati pe $ 172,889 kusvika ku $ 188,859 pamushonga. Izvi zvinenge zvakapetwa kaviri mari yekurapa kwemishonga mitsva, uye iyo yakabatanidzwawo zvakanyanya kuwedzererwa uye nemigumisiro.
Iko mari yekubudirira kuongororwa inzira yakasiyana yekuongorora kukosha. Iyi inongororwa inofunga nezvekudhura kwemishonga uye kutarisirwa mazuva ano pamusoro pemari ipi zvayo yekuchengetedzwa nekudzivirira zvirwere mune ramangwana. Nenzira dzakawanda, idzi marudzi ekuongorora zvinoratidza kuti kupindira kwakagadzikana kwakanyanya kunosanganisira iyo nzira inodhura zvishoma kudarika $ 20,000; iyo inobva kubva ku $ 20,000 kusvika ku $ 100,000 inodhura yakawanda-inoshanda; uye kupindira kunodhura madhora anodarika $ 100 000 zvichida mari inoshanda-inoshanda. Kushandisa chiyero umo madhora makumi mashanu nemakumi mashanu ehutano hwakagadziridzwa gore rehupenyu hunoonekwa huri kukosha, mazhinji emishonga mitsva inouya inosvika kana kuti yakapoteredza chiyero ichocho. Kana tikafunga pamusoro pemari inogona kuderera pasi inoshandiswa nekushanyirwa kwekurapa uye kuongororwa, kusingarevi zvimwe zvisingambozivikanwi asi njodzi chaiyo yekenza yeropa, cirrhosis uye chidimbu chekuvhara chiropa, zviri nyore kuona kuti izvi zvinogona kutongwa sei-zvinoshanda.
Zvisinei, mari inobatsira haisi yakafanana neyakakosha. Izvo zvave zvichifungidzirwa kuti zvingadai zvichitengesa hurongwa hwehutano hwehutano anenge $ 139 mabhiriyoni ekurapa munhu wese muUnited States ane chirwere che hepatitis C. Zvirongwa zvine hurongwa hwemishonga husinganzwisisiki hwakadai sehurumende dzakawanda dzehurongwa hweMedicaid, izvi zvinoreva kurega kuvhara kana kuwana mari kubva kune chimwe chirwere. Nzvimbo dzakawanda zvirongwa zveMedicaid zvirongwa zvekare zvakagadzira chirongwa chekugadzirisa umo varwere chete vane zvikamu zvepamusoro zvakanyanya zvechirwere vanofanirwa kubvunzurudzwa kurapwa, uye kunyange ipapo kune nguva dzakawanda matambudziko anowedzera kukundwa.
> Sources:
Chhatwal J, Kanwal F, Roberts MS, Dunn MA. Kutengesa-E kugadzirisa uye bhajeti Chiitiko cheHepatitis C Virus Treatment NaSofosbuvir neL edipasvir muUnited States. Ann Intern Med. 2015; 162 (6): 397-406.
> Etzion O, Ghany MG. Mushonga weHeight Cost YeHepatitis C Virus Treatment. Ann Intern Med. 2015; 162 (9): 660-1.
> Reau NS, Jensen DM. Sticker Shock and The Price of New Treatment for Hepatitis C: Ndizvo Zvakakosha Here? . Hepatology. 2014; 59 (4): 1246-9.
> Van der meer AJ, Veldt BJ, Feld JJ, et al. Kushamwaridzana Pakati Patsigiro Rinosimbiswa Nezvechikonzero Nezvose-Chikonzero Kufa Pakati Pevarwere Vanorwara Hepatitis C uye Advanced Hepatic Fibrosis. JAMA. 2012; 308 (24): 2584-93.