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Peginterferon-Ribavirin, Failed it twice. Incivek, Failed it. Sovaldi Olysio, failed it. Harvoni, failed it... Transplant Patient Zepatier and Sovaldi...we'll find out!

Monday, July 20, 2015

Who cares about the TPP anyway?

Since I was diagnosed with Hep C (HCV) when I was 13...
I ignored the problem, grew detached and depressed.
At 18...I fought the problem, the idea that I was sick, that I could live a normal life.

At 22...I lost.
At 23...I lost, I thought the key was to improve myself, to focus inwards.
At 26...I lost, I became more honest, more humble and focused on helping others.
At 28...I lost, I put my heart into text and hope that my growing disabilities would not hamper my new found advocacy.
At 29...I lost, I have never been more inspired by those around me than ever before. I have never been more hopeful and afraid of the amazing potential we now possess.

With all of the new meds, what should I be afraid of?

Myself. I am not even 30, and I have end stage liver disease. I should rephrase myself, this is what I am afraid of:  anyone getting to F4 cirrhosis for no reason.

I am already too late. For those coming close, who are denied treatment for the thousands upon thousands of people who could be cured but will not be.

Present restrictions of new HCV meds will force people on Medicaid to wait until they have irreparable damage before they even have access in nearly a dozen states.

Normally states would attempt to grab discounts from the pharmaceuticals to give more people access to the meds they need. In fact the ACA gives the states better leverage to do just that.

So what's the deal?

Even Carve-out options right now are being held in reserve...why?

Joseph Stiglitz has been critical of the deal for it's expansions of 'Big Pharma' patents.

States can't lobby for decent rates right now, because pharmaceutical companies can hold out and wait for the results of the TPP.
If the TPP is successful it will create a very different atmosphere for pharmaceutical companies.
Presently states use their Medicaid groups to get discounts. This works by a simple principle: The more people in your healthcare group, the better discounts you can ask for.

There are hundreds of healthcare groups in the US. The biggest groups, like Medicaid, can ask for the best discount. The TPP will allow for stronger and longer patents, limiting access to generics. Which means Medicaid will have to coax discounts of brand name pharmaceuticals more often and for longer periods of time.
This alone will mean less effective discounts, higher medical costs, and higher insurance premiums.
Let's not forget about the hundreds of millions of people who will be trying to do the same thing Medicaid is doing...at the same time.

The biggest groups get the discounts.

Japan has a nationalized healthcare system with a population of around 125 million people.
Canada has a nationalized healthcare system with a population of around 35 million people.
Millions more live in New Zealand, Singapore, Australia, Peru, Mexico, Brunei, Vietnam, Malaysia, and Chile.

Each group would have to compete with each other for discounts, which means every single group gets less of a discount. Which means more restrictions, and less access.

The loss of bargaining power would healthcare prices in every country to rise. Including countries who aren't members of the TPP.

We hoot and holler about Gilead making billions over the past year with new HCV meds...but that's nothing compared to what all pharmaceuticals will make if the TPP passes.

We don't just lose money. We don't just lose Jobs.
The TPP will indirectly hasten the deaths of hundreds of thousands of people with Hepatitis C.

1 comment:

  1. I regret the situation you're in Rick.
    I think you are very courageous and admire your strength.
    Don't give up hope because surely there will be more treatment options next year for post transplant patients.

    Today I'm waiting for results of my wife's 3 months SOV-SIM therapy but the signs are not positive with a cirrhosis nearing decompensation.

    I wish you the best of luck and keep on writing!