Inani eliphakeme lezinkanyezi zemithi emisha ye- hepatitis C liye lashaqisa, futhi ngokuqinisekile liphazamisa labo abangase babhekane ne-co-pay ephakeme ephaketheni, noma okubi nakakhulu, benqatshelwa ukukhishwa. Lokhu kubamba umbuzo ocacile: kungani le miyeza egcina impilo ibiza kakhulu? Kubalulekile ukugcizelela phambili ukuthi le mithi isindisa ukuphila .
Bavimbela umdlavuza wesibindi, ugweme ukuqhubekela phambili ku-cirrhosis, futhi ungagwema ukufa noma isidingo sokufakelwa kwesibindi.
Ake siqale ekuqaleni futhi silandele indlela yethu kuze kube manje. Ngonyaka ka-2010, i-interferon ne- ribavirin kwakuyizinga elijwayelekile lokwelapha nge-hepatitis C. Ngenkinga ejwayelekile kakhulu (i-genotype 1), izinga lokuphumelela lalingamaphesenti angaba ngu-50, futhi ngisho nalokhu kwaba nezindleko ezinkulu ngokwezenzakalo ezimbi, isikhathi sokwelashwa (Izinyanga ezingu-6-12), kanye namanani entengo ($ 50,000- $ 70,000) ngokucubungula ukuhlolwa kokuhlolwa kwegazi nokuvakashelwa kwehhovisi okudingekayo ngaleso sikhathi.
Ngo-2011, i-wave yokuqala yama-anti-antiviral agents ( DAA s) yamukelwa (i-telaprevir ne-boceprevir), eyaphumelela emaphesenti angu-70 kodwa nayo yayidinga ukuphathwa ngokubambisana ne-interferon ne-ribavirin. Imiphumela emibi yokwengezwa yale mithi inciphise intshiseko naphezu kwezinga eliphakeme lempumelelo nezindleko eziphakeme.
Iziguli zazifisa ukwelashwa okungenakho imiphumela ye-interferon, yesikhathi esifushane futhi nesilinganiso esiphakeme sokwelapha.
Kusukela ngo-2016, ama-multiple agents ngisho amasha avunyelwe yi-FDA ngamanani okuphumelela avame ukufinyelela amaphesenti angu-90 aphulukisiwe noma aphakeme ngemiphumela emibi embalwa. Ngo-2013, i-first of these agents entsha yafika (sofosbuvir [Sovaldi] kanye ne-simeprevir [Olysio] ).
Amanani wamanani amaningi alawa ma-agent ayenomqondo olinganayo, kanti amanye abiza imali engu-$ 1000- $ 1200 ngamaphilisi ngo-2016. Iphilisi ngalinye! Ukuqeqeshwa kwezinyanga ezingu-12 kungadla phakathi kuka- $ 86,000- $ 94,000-kungabandakanyi ukuvakashelwa udokotela noma ukuhlolwa kwelebhu. Bambalwa abangakwazi ukukhokhela lezi zithunywa ngaphandle kosizo lomshuwalense omkhulu kakhulu.
Ngakho Ngubani Onquma I-Tag Price?
Impendulo emfushane ukuthi inkampani yezokwelapha eyenza umkhiqizo ibeka inani. Leli yizindleko zokuthenga jikelele (WAC). Abaphoqelekile ukuhlinzeka ngokulungiswa. Kodwa-ke, kukhona amaqiniso afanele ukucabangela kulokhu. Kudingeka, okungenani, i-$ 2.6 billion futhi kuthatha iminyaka engu-10 ukuba imithi ifinyelele imvume ye-FDA, kanti kuphela izidakamizwa ezimbili eziyishumi ezidayiswayo zihola ngokwanele ukumboza izindleko zabo zokuthuthukiswa, ngokusho kocwaningo oluvela eTufts University. Abaphathi be-Pharmacy Benefits (PBMs) kanye ne-Veteran's Affairs bangakwazi futhi baxoxe ngezaphulelo ezingamaphesenti angama-46 noma ngaphezulu kwezinye izimo. Lokhu kusiza ngokucacile, kodwa Medicare ivunyelwe ngokomthetho ukuxoxisana nokukhokha intela egcwele. Njengoba cishe amaphesenti angu-70 weziguli ezine-hepatitis C e-United States "zingama-baby boomers" azalwa phakathi kuka-1945 no-1965, uMedare uba ngumhlinzeki wezempilo omkhulu.
Ngakho-ke, uma uhlelo ludinga isilinganiso semali yokukhokhela imithi yamaphesenti angama-20, okungase kungabonakali ngokweqile imishanguzo yegazi, lokhu kungaba ngu-$ 20,000 esikoleni se-12 sohlelo lwe-hepatitis C. Futhi kabili ukuthi uma kukhethwe amasonto angu-24.
Ingabe Kuyazuzisa?
Ukushaqeka kwe-sticker yemithi emisha kwaholela abaningi ukuba bangabazi ukuthi izinzuzo zezokwelapha zafanele yini izindleko. Okokuqala, lezi zindlela zokwelapha zihlotshaniswa nezinga eliphezulu "lokuphulukisa" ezingaphezu kwamaphesenti angama-90. Ukwelashwa kwesibalo se-hepatitis C kunomthelela omkhulu ekuphikeleni isikhathi eside kanye nekhwalithi yokuphila. Akukhona kuphela ukwehla "kokufa kwezinto zonke", kodwa kukhona nokunciphisa okuphawulekayo isidingo sokugcina sokufakelwa kwesibindi nokuthuthukiswa komdlavuza wesibindi.
Labo abangenayo i-cirrhosis ngenkathi yokwelashwa bangalindela ngokujwayelekile njengokuphila okuvamile njengoba bekungaba khona ngaphandle kwesifo se-hepatitis C. Empeleni, esinye sezizathu zamanani aphezulu ngemikhiqizo yezokwelapha yimali engezansi edingekayo ekudingeni ukuthi bambalwa ukufakelwa kwesibindi.
Ngabe singaluthola kanjani enye imali? Kukhona ngempela izindlela eziningana eziye zahlolwa. Enye indlela elula ukubala izindleko zemithi nemithi yanamuhla uma kuqhathaniswa namazinga amadala. Isibonelo, uma ukwelashwa kwasekudala kungabizi kodwa kwalapha amaphesenti angu-50 kuphela weziguli eziphathwayo, izindleko zokuphulukisa iziguli eziyikhulu ezingamaphesenti zingenza lokhu kube kubi kakhulu emphakathini kunemithi ebiza kakhulu ephilisa amaphesenti angama-95. Lokhu kuye kwafakazela ukuthi kuyindaba. Imithi ekhulile eyayihlanganisa i-peginterferon, i-ribavirin kanye ne-telaprevir ye-boceprevir (izinga lomuthi wokwelapha ngo-2011), phakathi kuka-$ 172,889 kuya ku-$ 188,859 ngomuthi ngamunye. Lokhu cishe cishe kabili izindleko zemithi yokwelapha emisha, futhi nazo zihlotshaniswa nobuthi obukhulu kakhulu nemiphumela emibi.
Ukuhlaziywa kwezindleko zokusebenza ngezimali kuyindlela ehlukile yokuhlola inani. Lezi zihlaziya zibheke izindleko zemithi nokunakekelwa namhlanje kunoma yikuphi ukugcinwa kwezindleko zokuvimbela izifo esikhathini esizayo. Ngokuvamile, lezi zinhlobo zokuhlaziya ziphakamisa ukuthi ukungenelela okunemali kakhulu kuhlanganisa lezozinqubo ezibiza imali engaphansi kwezingama-$ 20,000; lezo ezivela ezigidini ezingama-20,000 kuya ku-$ 100,000 ziyizindleko ezilinganiselayo; futhi ukungenelela okubiza okungaphezu kwamaRandi ayizigidi ezingu-100 kungenzeka ukuthi kuyabiza imali. Ukusebenzisa isilinganiso lapho u-$ 50,000 weminyaka yokuphila ehlelwe ngayo ngekhwalithi kubhekwa njengenani, iningi lezokwelapha ezintsha ziza noma zizungeze leso sibalo. Uma sicabanga ngezindleko ezingase zibe phansi ezihambelane nokuvakashelwa nokuhlolwa kwezokwelapha, singakhulumi ngengozi engavamile kodwa engokoqobo yesifo somdlavuza wesibindi, isifo somzimba nesidingo sokufakelwa kwesibindi, kulula ukubona ukuthi lezi zingabhekwa kanjani izindleko.
Kodwa-ke, izindleko eziphumelelayo azifani nezindleko. Kucatshangwa ukuthi kuzodala imboni yokunakekelwa kwezempilo cishe amaRandi ayizigidi eziyizinkulungwane eziyi-139 ukuphatha wonke umuntu e-USA onesifo sofuzo C. Ngezinhlelo ezinomthelela wezinhlelo eziphathelene nemithi ezifana ne-state Medicaid, lokhu kusho ukuthi kungavimbela ukufinyelela noma ukuthatha imali kusuka kwesinye isifo. Ngakho-ke izinhlelo eziningi ze-Medicaid izinhlelo ziye zakha uhlobo lokulinganisa lapho iziguli kuphela ezinezigaba eziphakeme kakhulu zezifo ezifanele ukucubungula ukwelashwa, futhi ngisho noma kunjalo zivame ukuba nezithiyo ezengeziwe okumelwe zinqobe.
> Imithombo:
Chhatwal J, Kanwal F, Roberts MS, Dunn MA. Ukusebenza kwezindleko-E kanye nomthelela wokuhlahlozwa kwesabelomali we-Hepatitis C Virus Treatment ne-Sofosbuvir ne-edipasvir e-United States. U-Ann Intern Med. 2015; 162 (6): 397-406.
> Etzion O, Ghany MG. Umuthi wezindleko eziphezulu ze-Hepatitis C Virus Treatment. U-Ann Intern Med. 2015; 162 (9): 660-1.
> Reau NS, Jensen DM. Ukunyathelisa Isitifiketi Nenani Lemithi Esha Yokwelapha Yesifo Se-Hepatitis C: Ingabe Kuwusizo? . I-Hepatology. 2014; 59 (4): 1246-9.
> Van der meer AJ, Veldt BJ, Feld JJ, et al. Ukubambisana Phakathi Kwempendulo Eyisondlo Eqinisiwe Nokwenza Okubangela Zonke Iziguli Phakathi Neziguli Eziphethe I-Hepatitis C Engaphelele ne-Advanced Hepatic Fibrosis. I-JAMA. 2012; 308 (24): 2584-93.