CBS news report (12/1/15): most veterans denied HCV meds


We have all read news stories about the difficulty veterans with active chronic HCV infection are having getting treated with Sovaldi at the VA. Some articles express a more reality-based report on the service-connected HCV outbreak among Vietnam veterans.   Is there a shift in attitude away from the offensive myth of widespread IVDU in this much maligned veteran population?  

Although we know that IVDU was rare in Vietnam from a 1973 government report, service persons who did engage in this behavior were a health menace to their comrades in combat and during any other events when their blood was transferred on and into another person’s body and blood stream..  (They were a menace to sex workers too.) During a typical tour of duty in Vietnam, exposure to IVDUers bodies, dead or alive, were in fact a service-connected HCV risk factor that should be added to the existing long long list of SC risk factors.  

But the most devastating transmissions of hepatitis occurred during transfusions due to the huge viral loads in the blood bags.  CBS (LINK):  

cbs

“In 2013, Vietnam veteran Zion Yisrael (right, CBS image) was told he had five years to live. He has stage 4 liver disease, caused by hepatitis C — which has infected as many as 230,000 veterans. Most veterans contracted it in Vietnam where it was spread by battlefield blood transfusions and vaccinations.

So far they have treated about 35,000 veterans, that’s just 15 percent of the veterans infected with hepatitis C.”

Gilead’s gouging policy has resulted in even fewer Medicaid HCV patients getting treated–only 3%.  According to the Senate Finance Committee press conference, “…in 2014, Medicaid programs spent $1 billion on Gilead’s Hepatitis C drugs, yet more than 97% of Medicaid patients went untreated.”  Medicare costs were even higher.

The  144-page bipartisan report is a marketing case study. The pdf link is below.

 SFC Sovaldi Report Executive Summary1 The Price of Sovaldi and Its Impact on the U.S. Health Care System (Full Report) 

Recent VA research (Nov. 14, 2015) gives different numbers using 2013 VA databases.

Cascade of Care for Hepatitis C Virus Infection Within the US Veterans Health Administration (Link to abstract on PUBMED).

OBJECTIVES:  We measured the quality of HCV care using a cascade of HCV care model.

METHODS:

We estimated the number of patients diagnosed with chronic HCV, linked to HCV care, treated with HCV antivirals, and having achieved a sustained virologic response (SVR) in the electronic medical record data from the Veterans Health Administration’s Corporate Data Warehouse and the HCV Clinical Case Registry in 2013.

RESULTS:

 Of the estimated 233,898 patients with chronic HCV, 77% (181,168) were diagnosed, 69% (160 794) were linked to HCV care, 17% (39,388) were treated with HCV antivirals, and 7% (15,983) had achieved SVR.

From the SFC’s report, “Prior to the virus’ identification in 1989, HCV was frequently spread through unscreened blood transfusions.”  

Definitions and synonyms for the word “frequently”:  all the time, habitually, very often, commonly, usually, as a rule, , ordinarily, again and again, over and over, repeatedly, regularly, routinely, more often than not and other none precise terms which sometimes can be quantified.   Pick your favorites.  I like “more often than not” and “all the time.”  

The military had been working on the hepatitis-transfusion problem decades before the “Vietnam Misunderstanding” as Nod sometimes puts it.  But the technologies had to be developed before anything could be done to break the chain of transmissions as each hepatitis virus was identified. transfuion korea

 Korean War transfusions.  Image: Walter Reed.

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15 Responses to CBS news report (12/1/15): most veterans denied HCV meds

  1. SPrice says:

    Kiedove….
    According to this new study, recruits are still getting hep c from unscreened blood while they are in the service. I’ll send you the full text. It’s a must read.
    http://onlinelibrary.wiley.com/doi/10.1002/hep.28303/abstract

  2. SPrice says:

    “Is there a shift in attitude away from the offensive myth of widespread IVDU in this much maligned veteran population? ”

    Of course. We educated the reporter for several weeks. Stay tuned, there’s a second part coming up.

    BTW, Zion, the man they interviewed, received a call from the VA the day after the interview aired. They offered to treat him.

  3. Here is why Vets can not get this drug. A VA employee invented it, on VA time, then sold it for 400 million. Gilead then sells it back to VA for 594 dollars per pill.
    http://www.disabledveterans.org/2015/12/03/va-doctor-invented-hepatitis-c-cure-sold-it-for-400-million-profit/

  4. woodguy11 says:

    One other thing ….The Red States (GOP) turned down Medicaid …there are 32 states that have (GOP) govenors

  5. woodguy11 says:

    I used to help guys with removing the needle because they would nod out before they could pull it out….Before you went home there would be a pee test and if it came out positive you stayed 2 weeks extra and went through detox. I never did these IVD because I seen what it did to these guys. Not good. I was strictly a pot head. LOL Ray

    • Kiedove says:

      Pot was not a safety issues for HCV of course. IVDUers today are called super-spreaders. Most post-screening tests, say, from 1991, led to a drastic decline in HCV transmissions from transfusions in developed countries who had access to it. Most new cases of HCV transmissions these days is due to IVDU we are told. My old Marine never saw IVDUers in Vietnam.

      But here is one example of a transmission events. An injured solder gets a transfusion of virus-contaminated blood. He recovers and goes back into the fray. Now he is a carrier/host. Stressed out, he stupidly shoots up a drug with two other stupid buddies with the same needle. Now, the two stupid buddies receive the virus too. Let’s say, all three never try IVU again. Good, but we now have three infected soldiers.

      Will that be the end of their risk to others? No. Why? Lets say buddy # 1 is shot and killed by the enemy or friendly fire. His body is oozing infected blood. Other hepatitis-free soldiers have to handle his body and get it into a body bag. They get blood on them. One has open scratches on his hands. What goes on our body has a way of getting into bodies despite our defenses. Broken skin, no matter how small, even invisible, create an opportunity for the virus to live on in a new host. Until buddy # 1 is buried, his body is a threat. After burial, no more transmissions will happen from him. But the other two dopes, they are a danger to others they come in bodily contact with for decades unless their immune systems can clear the virus. Most will become chronic carriers unless or until meds cure them.

      • woodguy11 says:

        I hear ya….they were nothing but a liability to the company. I think the VA hates us because we were dopers. I did pot day and night . Never drank until I came home to numb myself ….Didn’t know I was a carrier until 44. Even then I continued to drink .. to 55 then got put on the transplant list. I was in good shape because of the kind of work I did,..I felt good all the way to transplant except I had encepoloaphaly which is why I had to quit work. Still can’t figure out how I got it ,..air guns or an operation on my arm. Maybe the prostitute we all screwed ….15 of us. Now they are turning guys away because of the cost of the drug….What a bunch of crap huh?

        • Kiedove says:

          According to research VA HCV research I’ve read, you guys were all practically celibate! In terms of hepatitis sexual transmission, they use data for long term monogamous couples. I’ve seen one old Aussie research that is candid about their soldiers extracurricular activities in Vietnam. I’m still looking for VA research.

    • SPrice says:

      That’s the kind of things that won’t help your case.

      • woodguy11 says:

        Still can’t figure out how I got it….My first biopsy put me getting infected right around basic training. You know , I hired an attorney to do this and all I was trying to do was get a claim for Hep-C. They put about 7 items on the claim list. heart prostate sleep skin hearing . Why do you suppose they did that? Just got all my denials from The RO. So now it’s BVA. What kind of things are you talking about SPrice?

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