Ndalama yamakono ya zakuthambo ya mankhwala atsopano a hepatitis C akhala akudodometsa, ndipo ndithudi akudodometsa kwa iwo omwe angakhale akukumana ndi mthunzi wa mthumba, kapena mwakuya, akukana kufotokoza. Izi zikupempha funso lodziwika: chifukwa chiyani mankhwala opulumutsa moyowa ndi okwera mtengo kwambiri? Ndikofunika kutsindika kutsogolo kuti mankhwalawa amapulumutsa miyoyo .
Amapewa khansa ya chiwindi, kupeŵa kupititsa patsogolo ku chiwindi, ndipo amatha kupewa imfa kapena kusowa kwa chiwindi.
Tiyeni tiyambe kumayambiriro ndikuyang'ana njira yathu kufikira nthawi ino. Mu 2010, interferon ndi ribavirin ndizochiza chithandizo cha chiwindi cha matenda a hepatitis C. Chifukwa cha vuto lofala kwambiri (genotype 1), kupambana kwabwino kunali pafupifupi 50 peresenti, ndipo izi zinakhala ndi mtengo wambiri chifukwa cha zovuta, nthawi ya chithandizo (Miyezi 6-12), ndi mtengo wamtengo wapatali ($ 50,000- $ 70,000) poyang'ana kufufuza koyezetsa magazi ndi maofesi ofunikanso panthaŵiyo.
Mu 2011, gulu loyamba lokhazikika, loletsa tizilombo toyambitsa matenda ( DAA s) linavomerezedwa (telaprevir ndi boceprevir), zomwe zinapambana bwino mpaka 70 peresenti komanso zinayenera kuchitidwa mogwirizana ndi interferon ndi ribavirin. Zotsatira zina zowonjezereka za mankhwalawa zimakhala ndi chidwi cholimbitsa mtima mosasamala kanthu za mtengo wapamwamba wopambana komanso mtengo wapamwamba.
Odwala ankafuna mankhwala omwe anali opanda zotsatira za interferon, za nthawi yayitali komanso ndi mankhwala ochuluka.
Pofika m'chaka cha 2016, anthu ambiri omwe atha kukhala ovomerezeka atha kuvomerezedwa ndi a FDA omwe amawathandiza kuti azipeza bwino. Mu 2013, oyambirira mwa atsopanowa anabwera (sofosbuvir [Sovaldi] ndi simeprevir [Olysio] ).
Mtengo wa antchito ambiriwa wakhala wochititsa chidwi, wokhala ndi ndalama zokwana madola 1000- $ 1200 piritsi pa 2016. Piritsi! Maphunziro a milungu isanu ndi iwiri akhoza kutenga pakati pa $ 86,000- $ 94,000-osati kuphatikizapo dokotala kapena kuyesa kalasi. Ndi ochepa omwe angathe kugula antchito awa popanda chithandizo cha inshuwalansi yabwino.
Choncho Ndani Amadziŵa Tag Tag?
Yankho lalifupi ndilo kuti kampani yomwe imapanga mankhwalayo imakhala mtengo. Izi ndizo ndalama zogulira ndalama zambiri (WAC). Iwo sali okakamizidwa kupereka chilungamitso. Komabe, pali mfundo zina zofunika kuziganizira pankhaniyi. Zimalipira ndalama zokwana madola 2.6 biliyoni ndipo zimatenga zaka 10 kuti chigwirizane ndi FDA chivomereze, ndipo pafupifupi awiri mwa khumi mwa mankhwala omwe amagulitsidwa amapeza ndalama zokwanira kuti azipeza ndalama zowonjezera, malinga ndi kafukufuku wochokera ku yunivesite ya Tufts. Otsogolera opindula a pharmacy (PBMs) ndi Veteran's Affairs akhoza - ndi kuchotsa malingaliro oposa 46 peresenti kapena akuluakulu ena. Izi zimathandiza momveka bwino, koma Medicare imaletsedwa mwalamulo kukambirana ndi kulipira mtengo wathunthu. Popeza kuti pafupifupi 70 peresenti ya odwala matenda a hepatitis C ku United States ndi "ana aang'ono" omwe anabadwa pakati pa 1945 ndi 1965, Medicare amakhala wopereka chithandizo chamankhwala chachikulu.
Choncho, ngati ndondomeko imafuna kuti pakhale ndalama zokwanira 20 peresenti, zomwe zingawoneke mopitirira muyeso kwa mankhwala a magazi, izi zingakhale pafupifupi madola 20,000 pa masabata 12 a hepatitis C mankhwala. Ndipo kawiri kawiri ngati masabata 24 asankhidwa.
Kodi N'kofunika Kwambiri?
Kusokonezeka kwa mankhwala atsopano kunachititsa anthu ambiri kukayikira ngati thandizo lachipatala linali loyenera. Choyamba, mankhwalawa ndi ofunika kwambiri "mankhwala" kuposa 90 peresenti. Chithandizo cha vuto la chiwindi cha chiwindi C chimakhudza kwambiri moyo wautali ndi khalidwe la moyo. Sikuti "kuchepa kwa chiwopsezo kokha" kumakhala kochepetsetsa, koma palinso kuchepa kwakukulu kufunika kokhala ndi chiwindi ndi kukula kwa khansa ya chiwindi.
Anthu omwe alibe matenda a chiwindi pa nthawi ya chithandizo akhoza kuyembekezera kuti ali ndi moyo wamba monga momwe angakhalire opanda chiwindi chakumtunda C. Ndipotu, chimodzi mwa zifukwa za mtengo wapatali ndi makampani ogulitsa mankhwala ndizochepetsera kuchepa kwa kusowa kochepa chiwindi cha chiwindi.
Ndipanso tingawonetse bwanji mtengo? Pali njira zambiri zomwe zawerengedwera. Njira imodzi yosavuta ndikuwerengera mtengo wa mankhwala ndi mankhwala a lero poyerekeza ndi miyezo yakale. Mwachitsanzo, ngati mankhwala achikulire anali otchipa koma amachiritsa 50 peresenti ya odwala omwe amachiritsidwa, mtengo wochiritsa odwala 100 peresenti ukhoza kuganiza kuti izi zimapindulitsa kwambiri kwa anthu kusiyana ndi mankhwala ocheperapo mtengo omwe anachiritsa 95 peresenti. Izi zatsimikiziridwa kuti ziri choncho. Mankhwala achikulire omwe anaphatikizapo peginterferon, ribavirin komanso telaprevir ya boceprevir (muyezo wa chithandizo chamankhwala mu 2011), pakati pa $ 172,889 mpaka $ 188,859 pa machiritso. Ichi ndi pafupifupi mtengo wambiri pa machiritso atsopano, ndipo amathandizidwanso kwambiri ndi poizoni ndi zotsatira zake.
Kusanthula kwachangu ndi njira yosiyanitsira mtengo. Kufufuza uku kumawerengera mtengo wa mankhwala ndi chisamaliro lerolino pa mtengo uliwonse wotetezedwa ndi kupewa matenda m'tsogolomu. Kawirikawiri, machitidwe awa amasonyeza kuti njira zopindulitsa kwambiri zimaphatikizapo njira zomwe zimawonongeka zosakwana $ 20,000; Kuchokera pa $ 20,000 mpaka $ 100,000 ndizovuta kwambiri; komanso zopereka ndalama zokwana madola 100,000 ndizovuta kwambiri. Pogwiritsira ntchito mlingo umene $ 50,000 pamasinthidwe amatha chaka chokhala ndi moyo amawonedwa kukhala ofunika, ambiri mwa mankhwala atsopano amalowa kapena kuzungulira chiwerengerocho. Ngati tilingalira za ndalama zomwe zimakhala zochepa zomwe zimabwera poyendera ndi kuyezetsa kuchipatala, osatchula zochepa koma zoopsa zenizeni za khansa ya chiwindi, kuthamanga kwa chiwindi komanso kusowa kwa chiwindikiro cha chiwindi, n'zosavuta kuona momwe izi zingawonongeke.
Komabe, zopanda malire siziri zofanana ndi zotsika mtengo. Akuti pafupifupi ndalama zokwana madola 139 biliyoni zikhoza kuwononga makampani azachipatala kuti athetse munthu aliyense ku USA amene ali ndi chiwindi cha matenda a hepatitis C. Kwa mapulojekiti omwe ali ndi bajeti yapamwamba monga mankhwala monga boma la Medicaid, izi zingatanthauze kuchepetsa kupeza kapena kutenga ndalama kuchokera ku matenda ena. Zolinga zambiri za boma za Medicaid zakhazikitsa njira yothetsera vuto limene odwala omwe ali ndi magawo apamwamba kwambiri a matenda amatha kulandira chithandizo cha mankhwala, ndipo ngakhale nthawi zambiri pamakhala mavuto ena omwe angagonjetsedwe.
> Zotsatira:
Chhatwal J, Kanwal F, Roberts MS, Dunn MA. Kugwiritsa ntchito ndalama zamagetsi ndi Mphoto ya Chiwopsezo cha Hepatitis C Kugonjetsa Vuto Ndi Sofosbuvir ndi L edipasvir ku United States. Ann Intern Med. 2015; 162 (6): 397-406.
> Etzion O, Ghany MG. Chithandizo cha Kutsika Kwambiri kwa Chiwindi cha Chiwindi cha Hepatitis C. Ann Intern Med. 2015; 162 (9): 660-1.
> Reau NS, Jensen DM. Mtengo Wosasunthika ndi Mtengo wa Mankhwala Otsopano a Chiwindi cha Chiwindi: Kodi Ndizofunika? . Hepatology. 2014; 59 (4): 1246-9.
> Van der meer AJ, Veldt BJ, Feld JJ, et al. Kugwirizana Pakati pa Zomwe Zilimbikitsidwa Kugonana kwa Virological ndi Chomwe Chimayambitsa Imfa Pakati pa Odwala Amene Ali ndi Matenda a Chiwindi Odwala Matenda Achilendo Odwala ndi Matenda Achikulire Achikulire. JAMA. 2012; 308 (24): 2584-93.