Ixabiso eliphezulu leenkwenkwezi ze- hepatitis C elitsha liye latshitshisa, kwaye ngokuqinisekileyo lidibanisa abo banokujamelana ne-high-pocket-pay pay, okanye ngaphezulu, bayakuphika ingqalelo. Oku kubongoza umbuzo ocacileyo: kutheni le miyeza yokulondoloza ubomi ibiza kangaka? Kubalulekile ukugxininisa ngaphambili ukuba la mayeza asindisa ubomi .
Ukuthintela umdlavuza wesibindi, ugweme ukuqhubela phambili kwi-cirrhosis, kwaye unokuphepha ukufa okanye isidingo sokufakelwa kwesibindi.
Masiqale ekuqaleni kwaye silandele indlela yethu ukuya kulo mzuzwana. Ngo-2010, i-interferon kunye ne- ribavirin yimiqathango yokunyanga kwesifo se-hepatitis C. Kwi-strainpe ye-genotype 1), izinga lokuphumelela lalingama-50 ekhulwini, kwaye le nto yafika ngeendleko ezibonakalayo ngokubhekiselele kwiziganeko ezimbi, ixesha lokunyanga (Iinyanga ezi-6-12), kunye nexabiso lentengo (i-$ 50,000- $ 70,000) ngokuqwalasela ukuhlolwa kwegazi ngokubanzi kunye nokuhambela iofisi efunekayo ngelo xesha.
Ngo-2011, umbane wokuqala wokusebenza ngokuthe ngqo, i-anti-antial agents (i- DAA s) yavunywa (i-telaprevir ne-boceprevir), eyaphumelela kwimpumelelo kuma-70 ekhulwini kodwa kwafuneka ukuba ilawulwe ngokubambisana ne-interferon kunye ne-ribavirin. Iziphumo zecala ezongeziweyo zala mayeza awanciphise intshiseko naphezu kwezinga eliphezulu lokuphumelela kunye neendleko eziphezulu.
Izigulane zifuna unyango olungenayo imiphumo emibi ye-interferon, yexesha elifutshane kunye nezinga eliphezulu lokunyanga.
Ukususela ngo-2016, amaninzi amaninzi nama-Agent agunyazisiwe yi-FDA kunye namazinga okuphumelela amaxesha amaninzi afinyelela kuma-90 ekhulwini aphiliswe okanye aphakanyiswe ngemiphumo emibini. Ngomhla ka-2013, i-first of these agents new arrives (sofosbuvir [Sovaldi] kunye ne-simeprevir [Olysio] ).
Ithegi yentengo yabaninzi bala majelo ayenomdla ngokulinganayo, kunye nokubiza imali eyi-$ 1000- $ 1200 ngepilisi ngo-2016. I pilisi! Ikhosi yeeveki ezili-12 zonyango inokuhlawula phakathi kwe-$ 86,000- $ 94,000-kungabandakanywa ukutyelela ugqirha okanye ukuhlolwa kwebhu. Bambalwa abanokukwazi ukuzithengisa ezi zithunywa ngaphandle kwenkonzo ephezulu kakhulu yinshorensi
Ngoko Ngubani oMisela iTek Tag?
Impendulo emfutshane kukuba inkampani yezobisi ephuhlise umveliso ibeka ixabiso. Le yindleko yokuthenga ngokubanzi (WAC). Akunyanzelekanga ukubonelela ngokufanelekileyo. Kukho, nangona kunjalo, ezinye iinkcukacha ezifanele ukucatshangelwa kulo mba. Ixabiso, ngokwemyinge, i-$ 2.6 yezigidigidi kwaye ithatha iminyaka eyi-10 ukuba ifikelele kwi-ADA imvume, kwaye malunga neyesibini kwizinto ezilishumi ezithengiswayo zifumana imali eyaneleyo yokukhupha iindleko zokuphuhliswa kwazo, ngokutsho kwesifundo esivela kwiYunivesithi yaseTufts. Abaphathi be-Pharmacy Benefits (I-PBMs) kunye neMicimbi ye-Older's-and negotiated discounts of up to 46% okanye ngaphezulu kwezinye iimeko. Oku kunceda ngokucacileyo, kodwa i-Medicare ingavunyelwe ngokusemthethweni ukuthetha kunye nokuhlawula ixabiso elipheleleyo. Ekubeni malunga ne-70 ekhulwini yezigulane ezine-hepatitis C e-United States "ziintsana ze-baby boomers" ezazalwa phakathi ko-1945 no-1965, i-Medicare iba ngumboneleli wezempilo.
Ngoko ke, ukuba isicwangciso sifuna iqondo lokuhlawula umrhumo wee-20 zeepesenti, oko kungabonakali ngokugqithiseleyo kwimizi yecembelelo yegazi, oku kungaba ngama-20,000 kwiikhosi ezili-12 ze-hepatitis C. Kwaye kabini ukuba ikhefu ezingama-24 zikhethiweyo.
Ngaba Kuyafaneleka?
Ukutshatyalaliswa kwesitampu semithi emitsha kukhokelela abaninzi ukuba bangaba ngaba inzuzo yezokwelapha yayifanele ixabiso. Okokuqala, ezi zonyango zidibene nezinga eliphezulu "lokunyanga" ngaphezu kweepesenti ezingama-90. Ukunyangwa kwimeko ye-hepatitis C kunempembelelo enkulu kwixesha elide kunye nomgangatho wobomi. Akukhona nje kuphela ukuhla kwezinto "zokufa kwabantu bonke", kodwa kukho ukunciphisa okuphawulekayo ekudleni kokutsha kwesibindi nokuphuhliswa kwesifo somhlaza.
Abo bangenayo i-cirrhosis ngexesha lokunyanga banokulindela ngokuqhelekileyo ubomi njengokuba babeya kuba ne-hepatitis C. Enyanisweni, esinye sezizathu zokubaluleka kwexabiso eliphezulu kwishishini lokuxuba imithi yinkxaso ephantsi kwidingo elincinci ukufakelwa kwesibindi.
Sinokuphinda sihlole njani ixabiso? Kukho ngokwenene iindlela eziye zafundiswa. Enye indlela elula ukubala iindleko zonyango ngamachiza anamhlanje ngokumalunga nemigangatho yakudala. Ngokomzekelo, ukuba unyango oludala lucacile kodwa luphilisa iipesenti ezingama-50 zezigulane zonyango, iindleko zokuphilisa iipesenti ezingama-100 zezigulane zingacinga ukuba zenze ixabiso elininzi kuluntu kuneliyeza elincinci kakhulu eliphilisa ama-95 ekhulwini. Oku kuye kwangqina ukuba kunjalo. Amachiza asebekhulile aquka i-peginterferon, i-ribavirin kunye ne-telaprevir ye-boceprevir (umgangatho wonyango lononyango ngo-2011), phakathi kwama-$ 172,889 ukuya kwi-188,859 yeyonyango. Le phantse iphindwe kabini iindleko ngonyango lwamayeza amasha, kwaye nazo zidibaniswa ne-toxicity kunye nemiphumo emibi.
Uhlalutyo lwenkokhelo lwenkqubo yindlela eyahlukileyo yokuvavanya ixabiso. Ezi zihlalutyo ziqwalasela iindleko zamachiza kunye nokunyamekela namhlanje ngokubhekiselele kwindleko yokulondolozwa kwezifo kwixesha elizayo. Ngokuqhelekileyo, ezi ntlobo zokuhlalutya zibonisa ukuba ukungenelela okunokubaluleka okuninzi kubandakanya ezo nkqubo zibiza imali engaphantsi kwee-20,000 zamaRandi; abo abavela kwii-20,000 zamawaka ukuya kwii-100,000 zama-dollar banamanani asebenzayo; kunye nokungenelela okubiza imali engaphezu kwama-100,000 ahlawulwa ngexabiso. Ukusebenzisa isilinganisi apho i-50,000 zama-50 000 ngomgangatho wobomi obulungisiweyo obunjiweyo ufunyenwe njengenani, ininzi yezilwanyana zonyango ziza kungena okanye zijikeleze eso nani. Ukuba sicinga malunga neendleko eziphantsi kweendleko ezihambelana nokutyelelwa kunye nokuvavanywa kwezonyango, kungakhankanyi ngokubhekiselele kwimingcipheko yangempela yomdlavuza wesibindi, i-cirrhosis kunye nesidingo sokutshintshwa kwesibindi, kulula ukubona indlela ezi zingagwetywa ngayo iindleko.
Nangona kunjalo, ixabiso elinempumelelo alifani nexabiso elifanelekileyo. Kuqikelelwa ukuba kuya kuba neendleko zonyango lwempilo malunga neeyure eziyi-139 zamawaka ezigidi ukuphatha wonke umntu e-USA ophethe isifo se-hepatitis C. Kwiiprogram ngebhajethi yezilwanyana ezinjengeenkoliso ezininzi ze-Medicaid, oku kuthetha ukuthintela ukufikelela okanye ukuthatha imali kwesinye isifo. Uninzi lwezicwangciso ze-Medicaid izicwangciso ziye zakha uhlobo lokurhoxisa apho izigulane ezineziganeko eziphambili kakhulu zezifo zifanelekile ukuba ziqwalaselwe unyango, kwaye nangona kunjalo kukho izihlandlo ezongezelelweyo eziza kunqotshwa.
> Imithombo:
Chhatwal J, Kanwal F, Roberts MS, Dunn MA. Ukusetyenziswa kweendleko-E kunye neMpembelelo yeBhajethi ye-Hepatitis C ye-Virus Treatment kunye ne-Sofosbuvir ne-L edipasvir e-United States. Ann Intern Med. 2015; 162 (6): 397-406.
> Etzion O, Ghany MG. Uphiko lweNdleko ephezulu ye-Hepatitis C yeVirus Treatment. Ann Intern Med. 2015; 162 (9): 660-1.
> Reau NS, Jensen DM. I-Sticker Shock and Price of New Treatments for I-Hepatitis C: Ngaba Kuxabiseke? . Hepatology. 2014; 59 (4): 1246-9.
> Van der meer AJ, Veldt BJ, Feld JJ, et al. Umbutho Phakathi kweempendulo ezixhasayo nge-Virological and All-Cause Mortality Among Patients With Hepatitis C engapheliyo kunye ne-Advanced Hepatic Fibrosis. JAMA. 2012; 308 (24): 2584-93.