#Elbasvir
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Oh you think just cause streptomycin and erythromycin share a suffix they'd belong to the same class of antimicrobials? That's funny bitch. That's real funny. They don't even act on the same ribosome subunit.
#5 BILLION IDENTICAL PHARMACEUTICAL NAMES AAAAAAAAAAAAAAAAAAAAAAAAAAAAA#RIBANAVIR ELBASVIR TENOFOVIR DASABUVIR DORUNAVIR DORAVIRINE#could be a verse in the worst rap you've heard
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View Market Overview, Key in-line Products, Market Share Distribution, Competitive Dynamics, Regulatory Outlook, Pipeline Development, Growth Catalysts & Challenges, Leading Market & R&D Trends, Partnership & Deals Analyses, Global Sales forecast of in-line and pipeline products, Fast Growing Private Companies, Management Perspectives, Commentaries, Market Outlook & Summary Conclusions on Global Hepatitis C Virus (HCV) Treatment
#hepatitis#hepatite c#virus#merck#zepatier#Elbasvir#grazoprevir#gilead#abbvie#j&j#bristolmyers#roche#epclusa
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Thuốc Zepatier là thuốc điều trị viêm gan C mãn tính ở người trưởng thành. Thuốc Zepatier có sự kết hợp 50mg elbasvir và 100mg grazoprevir. Elbasvir và grazoprevir là những loại thuốc kháng virus, ngăn ngừa viêm gan C (HCV) sinh sôi và nhân lên trong cơ thể. Bên cạnh đó, thuốc có thể được dùng với thuốc ribavirin để điều trị. Hoặc được sử dụng trên bệnh nhân nhiễm HIV, tuy nhiên, thuốc này không phải là thuốc điều trị HIV hay AIDS.
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Does Harvoni Costs Drop and covered by Medicare?
No reasonable cost of hepatitis C virus (HCV) medicine has generated remarkable strain for patients and the healthcare solutions. These drugs price as much as $95,000 for a 12-week therapy but pick a 90% or better cure ratio, which many believe rationalize the cost.
While few problems have included cost efficient strategies to stop early stage patients from getting the treatment, legal actions have been filed issuing the ethos of these practices.
Lawgivers are now issuing to build codification that will get these patients with the treatments they require but a legal age of scheme don’t boost traction, according to a report published by Mediware.
It received FDA approval in past and was the first drug consider secure and effective without interferon. It was also the first accepted corrective treatment for HCV.
No previous treatments follow outputted in a comforted viral diseases response, which made sofosbuvir a really sought-after drug. Gilead Sciences costly the treatment at $1K per pill, creating the total sum of the treatment $84K
Foul then integrate sofosbuvir with a new drug, ledipasvir to build the even more great combination treatment for a Buy Harvoni Online. Harvoni’s total bill pay approx. $95K for a 12 week procedure.
If CDC evaluate are accurate and 3.5 m Americans have HCV, then therapy with Harvoni would cost payers $331 B which ware more than final amount drug expending in past year, according to say a report.
Although most other profession drugs only process a not a large number of patients, HCV drugs treat a large patient society and get manufacturers with great opportunities to product specific income.
Engaging, sofosbuvir enough costs $900 in Egypt, and $55,000 in Canada, considerably less than the cost in the US. This has generated some lawmakers to cite Gilead of cost gouging, and limiting manage to positive treatments, giving to the report.
Delightful, sofosbuvir only costs $900k in Egypt and $55 K in Canada, consider less than the cost in the US. This has generate some lawmakers to summons Gilead of cost delve and limiting manage to effective treatments, according to the report.
In some states, Medicaid receiver may not have equal preference to the medicines. US lawmaker have announced that some states cover 9.1% of soul for HCV treatment, while others only cover less than 1%.
Medicaid is unable to cover treatment for all medical, since covering 1 treatment with Harvoni prices the same as the yearly health care costs for 29 medical, which insights the requires for cost efficient, according to the analysis.
Both private and public insurers have had to create eligibility requirements that prioritize patients with liver damage, and those who have failed to respond to less costly treatments due to the high price of newer drugs. However, the Department of Veterans Affairs recently announced they would cover HCV treatment costs for all veterans as a result of increased funding and decreased drug costs, according to the report.
US President Donald Trump advising for lower medical costs, patients with HCV may boost explored manage to treatment.
Request such as providing Medicare cost conference, capping out-of-pocket drug prices, importing drugs, and limiting manufacturer’ expending on patient marketing could all output in lower HCV drug costs, the entrepreneur wrote.
Fighting has also been seen to smash HCV medicine costing, and will mostly continue to do so in the future as more drugs receive regulatory approval.
The FDA’s oistive assign of Viekira Pak (ombitasvir, paritaprevir, and ritonavir drugs; dasabuvir tablets) in 2014 effected the pricing of Harvoni. The latest approval extract support from Express Scripts, who then fallen Harvoni and sofosbuvir for patients with HCV genotype 1.
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What are the most common side effects of Harvoni?
This output in Gilead’s stocks taking a 20% hit, assistance them to provide discounts for Harvoni to few money providers. If manufacturers get alike actions, medicine costs may be decreased even further.
The most current approval of Merck’s Zepatier (elbasvir and grazoprevir) generated waves for many reasons. First, the drug’s cure rate was 97% to 100% in patients with HCV genotype 4, and 94% to 97% in patients with genotype 1, which is bigger compared with other medicines.
Remarkable, the cost for the medicine was only $54,600 for 12-weeks of routine, which improves manage to cost efficient, according to the report.
A pipeline drug, odalasvir, being build by Achillion medicament and Johnson & Johnson, also has the unique to decrease drug prices. The medicine has shown a 100% cure rate in as little as 6 weeks in combination with sofosbuvir. Not a huge treatment spans will mostly output in less costly drugs, the authors noted.
Is $GILD's move to sell lower-priced versions of its hepatitis C drugs the start of something bigger in how we pay for drugs? @joewalkerWSJ explores the company's plans to sell authorized generics of Epclusa and Harvoni: https://t.co/QzusjKORX9
Despite treatment for HCV being health related to want, payers still do not think the high prices for the medicine warrant widespread treatment. However, critics may collector store that in the long run, payers are costing themselves more money.
Patients who do not get treatment for HCV are more fairly to build liver cancer and kind 2 diabetes, experience plaque build-up in the arteries, and have an increased risk of stroke, according to the report.
While Gilead’s drugs remain some of the highest priced on the market, the entrance of new, lower cost drugs will likely drive drop the price of HCV treatment over time?
Until that happens, specialty pharmacies and their pharmacists should focus on directing patients to copay assistance programs, and help patients adhere to treatments, the report concluded.
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HCV is a small, enveloped, single-stranded, positive-sense ribonucleic acid (RNA) virus that occurs in seven major genotypes, which are classified from one to seven. It causes inflammation of the liver and leads to decreased liver function or failure.
The infection is typically asymptomatic until later stages, which takes several years. The chronic viral infection is characterised by cirrhosis, which is associated with complications such as bleeding, jaundice, fluid accumulation in the abdomen, infections or liver cancer.
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VIROPIL DỰ PHÒNG VÀ ĐIỀU TRỊ ARV
Giá bán: 2.000.000₫
Thuốc Viropil được sử dụng để điều trị nhiễm HIV-1 áp dụng cho người lớn và bệnh nhi có cân nặng ít nhất 40kg
Thành phần:
Dolutegravir 50mg
Tenofovir disoproxil fumarate 300mg
Lamivudine 300mg
Thuốc Viropil là thuốc gì?
Thuốc Viropil là loại thuốc được dùng trong quá trình điều trị bệnh HIV. Nhờ khả năng ức chế và kháng virus HIV hiệu quả, Thuốc Viropil là phương pháp đặc trị HIV được ứng dụng phổ biến tại các phòng khám và cơ sở y tế hàng đầu.
Thuốc Viropil có công dụng hạn chế sự lây lan của HIV trong cơ thể người bệnh, giảm nguy cơ xuất hiện các biến chứng liên quan HIV. Sử dụng Viropil sau một thời gian, hệ miễn dịch của bệnh nhân sẽ được phục hồi và bảo vệ đáng kể, giúp duy trì sức khỏe.
Tuy nhiên, cũng như các loại thuốc HIV khác, Viropil không có khả năng điều trị dứt điểm bệnh HIV. Người bệnh vẫn phải học cách “sống chung” với căn bệnh này.
Thành phần thuốc Viropil
Dolutegravir 50mg
Dolutegravir giúp hạn chế tối đa sự tích hợp của gen integrase HIV. Từ đó ngăn ngừa virus HIV nhân đôi và phát triển trong cơ thể con người. Dolutegravir được nghiên cứu là an toàn cho phụ nữ có thai hoặc đang cho con bú.
Tenofovir disoproxil fumarate 300mg
Thành phần này có tác dụng ngăn cản quá trình tổng hợp DNA của virus HIV. Nó giúp chống nhiễm khuẩn vượt trội, giúp thúc đẩy quá trình kháng virus.
Lamivudine 300mg
Lamivudine là thành phần rất hiệu quả trong việc kháng retrovirus, từ đó giúp ức chế enzym phiên mã ngược trong cơ thể người bệnh. Giúp bảo vệ hệ miễn dịch tối đa khỏi sự tấn công của virus HIV. Ngoài ra, đây là thành phần giúp kháng sự phát triển của virus viêm gan B hiệu quả.
Chỉ định thuốc Viropil
Thuốc Viropil ược sử dụng để điều trị nhiễm HIV-1 áp dụng cho người lớn và bệnh nhi có cân nặng ít nhất 40kg.
Nếu bệnh nhân bị ức chế virus học, sẽ dùng Rilpivirine. Đây là một chế độ hoàn chỉnh để điều trị nhiễm HIV-1 ở người lớn để thay thế các loại thuốc kháng retrovirus hiện tại.
Liều dùng – Cách dùng thuốc Viropil
Người lớn: Nên sử dụng thuốc với liều lượng 1 viên/lần/ngày. Nên uống thuốc trong bữa ăn.
Bệnh nhân dưới 18 tuổi: Không có liều lượng cụ thể, bạn nên tìm đến các y bác sĩ để được kê đơn phù hợp.
Bệnh nhân trên 65 tuổi: Không có liều lượng cụ thể, bạn nên tìm đến các y bác sĩ để được kê đơn phù hợp.
Chống chỉ định Viropil
Viropil chống chỉ định với những bệnh nhân được dùng đồng thời elbasvir & grazoprevir. Phản ứng quá mẫn được tạo ra do bệnh nhân chống chỉ định với thành phần của Viropil.
Sử dụng đồng thời Viropil với dofetilide, dẫn đến tăng nồng độ trong huyết tương của dofetilide dẫn đến độc tính.
Tác dụng phụ thuốc Viropil
Nhiễm axit lactic / gan to nặng với nhiễm mỡ, làm nặng thêm viêm gan B, khởi phát mới hoặc suy thận nặng.
Ở bệnh nhân đồng nhiễm HIV-1 và viêm gan C sẽ bị mất bù gan. Viêm tụy, giảm mật độ xương, giảm miễn dịch.
Chi tiết sản phẩm: https://phongkhamgalant.com/product/thuoc-viropil-du-phong-va-dieu-tri-arv
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Hepatitis Drugs Market Size worth USD 27,180.1 Million, Grow at a 4.1% CAGR by 2028 | Merck & Co., Gilead Sciences, AbbVie
Major players operating in the global hepatitis drugs market are focused on approval and launch of new products to expand their product portfolio. For instance, in 2018, Natco Pharma launched Hepcinat Plus, a fixed dose combination of Sofosbuvir-Daclatasvir tablets for the treatment of Hepatitis C in India.
The global hepatitis drugs market size was valued at US$ 21,848.3 million in 2019, and is expected to witness a CAGR of 4.1% over the forecast period (2021 – 2028).
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High prevalence of hepatitis is expected to propel growth of the global hepatitis drugs market over the forecast period. For instance, in May 2019, according to the study, ‘Prevalence of hepatitis B surface antigen (HBsAg) positivity and its associated factors in Rwanda’, published in May 2019, in BMC Infectious Diseases, the prevalence of hepatitis B surface antigen was 3.9% in the study population.
Initiatives to boost treatment and management of hepatitis is expected to offer lucrative growth opportunities for players in the global hepatitis drugs market. For instance, in 2017, the U.S. Department of Health And Human Service started the National Viral Hepatitis Action Plan 2017-2020 (Action Plan) for the treatment and management of hepatitis in the US.
Market Trends
The market is witnessing increasing demand for generic drugs. For instance in 2015, Gilead licensed its hepatitis C drug Sovaldi to seven generic drug manufacturers companies in India to make and sell a low-cost version of the medicine in 91 emerging economies.
The market is also witnessing approval and launch of new products. For instance, in 2016, The U.S. Food and Drug Administration approved Zepatier (elbasvir and grazoprevir) with or without ribavirin for the treatment of chronic hepatitis C virus (HCV) genotypes 1 and 4 infections in adult patients.
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High cost of manufacturing hepatitis drugs is due to high expenses incurred to procure raw materials such as active pharmaceutical ingredients (APIs) and drug intermediates is expected to limit growth of the global hepatitis drugs market.
Major players operating in the global hepatitis drugs market include, AbbVie Inc., Bristol Myers Squibb Company, Cipla Inc., F. Hoffmann-La Roche Ltd., Gilead Sciences Inc., GlaxoSmithKline PLC., Hetero Healthcare Limited, LAURUS Labs, Merck & Co. Inc., and Zydus Cadila.
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Iris Publishers-Journal of Archives of Pharmacy & Pharmacology Research-Expanding the Kidney Donor Pool through Use of Hepatitis C-Infected Donors: is it Time to Dive in?
Author by Dinesh Kannabhiran
Abstract
The survival benefit of kidney transplantation for patients with end-stage renal disease (ESRD) is well established. However, the demand for kidney donor organs greatly exceeds the current supply. The use of hepatitis C infected donors could increase the number of kidneys available for transplantation. The use of highly effective second-generation direct acting antivirals (DAAs) has been recently studied for the prevention of chronic hepatitis C virus (HCV) infection in kidney transplant recipients who are HCV negative and receive HCV infected kidney allografts.
Introduction
The survival benefit of kidney transplantation for patients with end-stage renal disease (ESRD) is well established. However, the demand for kidney donor organs greatly exceeds the current supply. The use of hepatitis C infected donors could increase the number of kidneys available for transplantation. The use of highly effective second-generation direct acting antivirals (DAAs) has been recently studied for the prevention of chronic hepatitis C virus (HCV) infection in kidney transplant recipients who are HCV negative and receive HCV infected kidney allografts. Small, open-label trials have demonstrated the feasibility of using DAAs as either pre- and post-exposure prophylaxis or as treatment after detection of HCV transmission. Short term outcomes illustrate 100% prevention of chronic HCV infection with renal function and allograft survival that are comparable to recipients of non-HCV infected kidney donors. Long-term allograft and patient outcomes are required to determine whether the use of HCV infected organs should be considered for all patients with ESRD waiting for kidney transplant. The survival benefit of kidney transplantation for patients with end-stage renal disease (ESRD) is well established [1,2]. However, the demand for kidney donor organs greatly exceeds the current supply which encourages organ procurement organizations and transplant centers to look for innovative strategies to increase the donor pool. Recently, the opioid crisis has increased the number of overdose deaths exponentially [3]. Additionally, the number of hepatitis C virus (HCV) seropositive donors increased from 452 organs per year to 1506 per year between the years of 2000 and 2016 but only 57% of the HCV seropositive kidneys were transplanted in 2016 [4]. The use of hepatitis C infected donors could increase the number of kidneys available for transplantation but this strategy has historically been avoided because of risk of HCV transmission as well as inadequate treatment response and risk of rejection with interferon-based regimens. The advent of highly effective secondgeneration direct acting antivirals (DAAs) has increased viral cure of patients with chronic HCV infection to more than 96% [5-7]. Ongoing research is investigating whether DAAs can be prescribed post-transplant to HCV negative recipients receiving HCV infected donors to increase the donor pool.
The Transplanting Hepatitis C Kidneys Into Negative KidnEy Recipients (THINKER) trial, was a prospective, open-label, nonrandomized trial that included a total of 20 kidney transplant HCV negative recipients who received hepatitis C infected kidneys, determined by HCV nucleic acid testing (NAT) [8,9]. Recipients were included if they were expected to have prolonged times on the wait list while being maintained on dialysis. Recipients could not have any contraindications to liver transplantation or evidence of liver disease detected by FibroScan imaging or serologic testing. Only HCV genotype 1 infected donor kidneys were included. Patients were assessed for HCV transmission on post-op day 3 and were started on elbasvir-grazoprevir (ELB-GRZ) upon detection of HCV infection. Participants with genotype 1a HCV were tested for baseline nonstructural protein 5A (NS5A) resistance mutations. Patients with genotype 1a/1b were treated with ELB-GRZ for a total of 12 weeks while patients with genotype 1a with NS5A resistance mutation were started on ELB-GRZ and ribavirin for 16 weeks total. Outcomes included HCV cure determined by sustained viral response at 12 weeks (SVR12) and adverse events attributable to HCV infection or DAA therapy with 1year follow-up. All patients received rabbit antithymocyte globulin induction therapy and triple immunosuppression maintenance with tacrolimus, mycophenolate mofetil, and prednisone. Twenty patients were included in the trial, of which 19 became HCV PCR positive by post-operative day 3 (range 2-4). The last patient became HCV PCR positive on day 5 after transplant. Seventeen donor allografts were infected with HCV genotype 1a and only 3 donor allografts had NS5A mutations. All patients had undetectable HCV PCR within 4 weeks of therapy. Renal function at 12 months was similar between patients who received a hepatitis C infected kidney donor and matched recipients who did not accept hepatitis C infected kidney donor. No episodes of allograft rejection occurred during treatment. Four patients developed low-level de novo donor specific antibodies (DSAs) that were detected during routine surveillance. Five patients experienced increased but transient elevations in aminotransferase levels which returned to baseline without intervention. One patient with ESRD due to IgA nephropathy was diagnosed with focal segmental glomerulosclerosis post-transplant with no evidence of recurrent IgA nephropathy. Of interest, 50% of donor organs were excluded in THINKER because of HCV infection that was non-genotype 1 [10]. For this reason, a second trial started, called Exploring Renal Transplants Using Hepatitis C Infected Donors for HCV Negative Recipients (EXPANDER), to utilize these discarded organs [11]. Overall, the methodology of EXPANDER was very similar to THINKER, however, EXPANDER included kidney donor organs infected with genotype 1–4 and DAA therapy was administered as pre- and post-exposure prophylaxis. One dose of ELB-GRZ was administered pre-operatively as pre-exposure prophylaxis. After transplant, patients with genotype 1a/1b and 4 were treated with ELB-GRZ for 12 weeks total. Donors with HCV genotype 1a were tested for NS5A mutation and recipients who received a HCV genotype 1a with NS5A mutation kidney allograft were prescribed ELB-GRZ and ribavirin for 16 weeks total. Patients who received genotype 2 or 3 organs were treated with ELB-GRZ and sofosbuvir (SOF) for 12 weeks total. If the donor allograft genotype was unable to be determined due to insufficient viral load, the recipient was treated with ELB-GRZ for 12 weeks.
Ten hepatitis C negative patients were transplant with hepatitis C infected kidneys. Each patient received one dose of ELB-GRZ prior to transplant. Post-transplant, 7 patients received 12 weeks total of ELB-GRZ for genotype 1,4, or unknown genotypes. No patients received an organ infected with genotype 1a with N5SA mutation. The remaining 3 patients had non-genotype 1 or 4 HCV and were treated with ELB-GRZ and SOF. SVR12 for all patients was 100%. No adverse events occurred related to HCV infection or DAA therapy. Like THINKER, one patient experienced increased aminotransferase levels which increased to 5 times greater than the upper limit of normal (ULN) and then returned to normal without clinical symptoms or intervention. While renal function of HCV infected recipients was not compared to non-HCV infected, matched controls, the median creatinine level at week 12 was 1.05 mg/dL (IQR: 0.9 – 2.0 mg/dL) and GFR was 63.5 mL/min (IQR: 47.8 – 69.9 mL/min). THINKER and EXPANDER both illustrated the feasibility of using highly effective DAA therapy as post-exposure prophylaxis in HCV negative recipients who receive HCV NAT positive donors. The participants of both trials were carefully selected under IRB and the DAA was supplied by pharmaceutical companies. A recent, single center experience by Molnar et al reported outcomes for the use of hepatitis C infected donors for hepatitis C negative recipients when used as standard of care treatment [12]. The standard of treatment was offered to all waitlisted recipients regardless of time of the waiting list or dialysis. Allograft donors were considered if they were HCV NAT-positive, donor age of 45 years or younger, and had a donor biopsy with less than 10% glomerular sclerosis. Recipient HCV PCR was not tested until 4–8 weeks after transplant. Once HCV RNA was positive, HCV genotype was tested and patients were started on glecaprevir-pibrentasvir (GLE/PIB), sofosbuvirvelpatasvir (SOF/VEL), or sofosbuvir/ledipasvir (SOF/LED) for at least 12 weeks as determined by hepatology. The hospital planned to pay for treatment if the third-party payor denied any patient HCV treatment. Standard immunosuppression was rabbit antithymocyte globulin induction with triple immunosuppression of tacrolimus, mycophenolate mofetil, and prednisone maintenance. Between March 1, 2018 and December 31, 2018, the program transplanted 53 hepatitis C negative kidney transplant recipients with HCV NAT positive donors. All patients had undetectable HCV RNA by 12 weeks of treatment. Renal function was similar to THINKER trial at 6 months post-transplant with eGFR 66 mL/min (IQR: 54–79). Forty-seven patients (89%) were treated with GLE/PIB, 5 patients (9%) were treated with SOF/VEL, and 1 patient (2%) was treated with SOF/LED. All insurance plans approved treatment within a median of 5 days of insurance application (IQR: 2–8). Eleven patients originally were denied by the third-party payor but were approved after appeal. Ten patients had AST > 3 times upper limit of normal and 8 patients had ALT > 3 times the ULN. All returned to baseline without intervention. One patient developed fibrosing cholestatic hepatitis. This patient was started immediately on DAA therapy and experienced compete resolution. Thirty-two (60%) of patients experienced low level CMV infection without tissue invasive disease. Eighteen patients (34%) developed BK viremia and 2 patient developed BK nephropathy on biopsy. Sixteen patients (30%) developed de novo DSA. Three patients had acute cellular rejection (ACR) and 1 patient had an episode of combined antibody-mediated rejection and ACR.
The short-term outcomes for kidney transplantation of HCV negative recipients using HCV infected kidney donors are excellent. The renal function and allograft survival in clinical trials are comparable to recipients of non-HCV infected kidney donors. Furthermore, the use of HCV infected kidney donors for transplantation decreases the patient’s wait time on dialysis [8- 12]. Emerging evidence is addressing some of the initial concerns about the use of HCV infected donors including cost-effectiveness of this strategy [13,14]. The study performed Molnar et al further illustrates that third-party insurance companies are paying for the therapy with approval of DAA therapy occurring in less than a week in most cases [12].
While initial studies increase the collective understanding of managing this patient population, some questions remain unanswered [8-16]. First, what is the optimal timing of DAA therapy? EXPANDER was the first study to attempt pre- and postexposure DAA prophylaxis strategy [11]. While the number of patients in this study was small, less patients in EXPANDER had elevated transaminase levels compared to either THINKER or the Molnar et al studies leading to the conclusion that avoidance of HCV infection through pre- and post-exposure prophylaxis may help to decrease transaminitis associated with HCV transmission [8-9,11-12]. Moreover, one patient in the Molnar et al. study developed fibrosing cholestatic hepatitis. The authors mention that DAA therapy was started early for this patient and the fibrosing cholestatic hepatitis resolved completely but no additional information was documented. Originally, the treatment protocol for this study started DAA therapy between 4–8 weeks posttransplant but evolved over time to start DAA therapy < 3 weeks after transplant. Further studies will help to elucidate if pre- and post-exposure DAA therapy is associated with less transaminitis compared to waiting to treat after confirmed HCV transmission. Another interesting finding of the Molnar et al study that is not mentioned in either THINKER or EXPANDER is the development of low level CMV viremia in 60% of patients and BK viremia in 34% of patients [8-9,11-12]. Two patients with BK viremia developed biopsy proven BK associated nephropathy (BKAN) but no patients had allograft loss during follow-up. It is unclear whether HCV viremia contributed to the concurrent CMV and BK viremias or whether this population of patients were at higher risk of these infections at baseline.
The detection of DSAs was noted in both THINKER and the Molnar et al study [8-9,11-12]. While no rejection episodes occurred during DAA treatment in the THINKER trial, 4 episodes of rejection were documented in the Molnar et al study; 3 episodes of ACR and 1 episode of mixed ACR and antibody mediated rejection. The grades and timing of these rejections were not discussed. It is unclear whether the rejections occurred during or after DAA therapy but it should be noted that the overall incidence of ACR for this cohort is similar to national outcomes [17]. Patients received rabbit antithymocyte globulin for induction therapy with a mean total dose of 4.9 mg/kg (±0.9 mg/kg). Target tacrolimus goal levels post-transplant and goal mycophenolate mofetil doses were not noted. Future studies should continue to monitor the development of DSAs and rejection in this patient population.
Overall, the utilization of HCV infected kidneys for HCV negative recipients is a promising strategy to increase access to transplantation and should continue to be studied. Current evidence suggests that HCV negative recipients who receive pre- and postexposure DAA prophylaxis or DAA therapy upon detection of HCV transmission can be transplanted with HCV infected kidneys with no documented chronic HCV transmission to date and excellent shortterm renal outcomes. Future studies should investigate the optimal timing of DAA therapy to decrease adverse events described in the literature including the development of DSAs, CMV and BK viremia, and elevated transaminase levels. Long-term allograft and patient outcomes should also be collected to determine whether the use of HCV infected organs should be considered for all patients with ESRD waiting for kidney transplant.
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Journals on Medical Research - BJSTR Journal
Efficacy and Safety of Elbasvir/Grazoprevir Combination Therapy for Chronic Hepatitis C by Masatoshi Kudo* in Biomedical Journal of Scientific & Technical Research https://biomedres.us/fulltexts/BJSTR.MS.ID.002403.php Objective: A phase III clinical study of combination therapy with elbasvir (EBR) and grazoprevir (GZR) was conducted in Japan, and the additive therapeutic effects were obtained. In this study, we report safety and efficacy of EBR/GZR combination therapy in a real-world practice. Methods: Sixty-two patients with chronic hepatitis C received EBR/GZR combination therapy from November 2016. Patients who achieved sustained virologic responses at 12 weeks (SVR12) were included in the study. A total of 40 patients were enrolled in this retrospective study. Thirty-eight patients were naive for direct-acting antiviral (DAA) therapy and two patients were previously treated with DAA. Results: All of 38 DAA-naïve patients achieved SVR12 by EBR/GZR combination therapy, whereas two patients with DAA failure prior to this treatment did not achieve SVR12. A total of 21 patients (52.5%) had cardiovascular diseases, and 5 patients (12.5%) had advanced kidney diseases with eGFR<30. All of these patients achieved SVR12, and the treatment was performed safely even in the presence of cardiovascular and kidney diseases. Conclusion: Clinical efficacy and safety of EBR/GZR combination therapy have been confirmed in this study. EBR/GZR combination therapy is extremely effective in chronic hepatitis C patients naive for DAA treatments. Administration of EBR and GZR therapy is safe in patients bearing cardiovascular and kidney disease. For more articles on Journals on Medical Research please click here bjstr Follow on Twitter : https://twitter.com/Biomedres01 Follow on Blogger : https://biomedres01.blogspot.com/ Like Our Pins On : https://www.pinterest.com/biomedres/
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ZEPATIER 50 mg/100 mg Film-Coated Tablet
ZEPATIER 50 mg/100 mg Film-Coated Tablet
ZEPATIER Film-Coated Tablets containing the active ingredient elbasvir (50 mg) and grazoprevir (100 mg); It is classified as Antiinfectives, Antivirals (Systemic), Direct-Acting Antivirals, antivirals for the treatment of HCV infections and elbasvir + grazoprevir, and is among the licensed drugs in the Medicines and Medical Devices Agency with the J05AP54 ATC code. ZEPATIER, which you can obtain…
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Hepatitis C Guide – Causes, Symptoms, Precaution and Treatment
Hepatitis C is a viral infection that causes liver inflammation, sometimes leading to serious liver damage. The hepatitis C virus (HCV) spreads through contaminated blood. Until recently, hepatitis C treatment required weekly injections and oral medications that many HCV infected people couldn’t take because of other health problems or unacceptable side effects. Today, chronic HCV is usually curable with oral medication taken everyday for two to six months. Still, about half of people with HCV don’t know they’re infected, mainly because they have no symptoms, which may take decades to appear.
Symptoms
Long term infection with hepatitis C virus is known as chronic hepatitis C. Chronic hepatitis C is usually silent infection for many years, until the virus damages the liver enough to cause the signs and symptoms of liver disease.
Signs and symptoms include-
• Bleeding easily
• Fatigue
• Poor appetite
• Yellow discoloration of the skin and eyes (jaundice)
• Dark colored urine
• Itchy skin
• Swelling in legs
• Weight loss
• Confusion, drowsiness and slurred speech
• Spider like blood vessels on skin
Every chronic hepatitis C infection starts with an acute phase. Acute hepatitis C usually goes undiagnosed because it rarely causes symptoms. When signs and symptoms are present, they may include jaundice, along with fatigue, nausea, fever and muscles aches. Acute symptoms appear one to three months after exposure to the virus and last two week to three months.
Acute hepatitis C infection doesn’t always become chronic. Some people clear HCV from their bodies after their acute phase, an outcome known as spontaneous viral clearance. Acute hepatitis C also responds well to antiviral therapy.
CAUSES
Hepatitis C infection is caused by the hepatitis virus (HCV). The infection spreads when blood contaminated with the virus enters the bloodstream of an uninfected person. Globally, HCV exists in several distinct forms, known as genotypes. The most common HCV genotype is type 1.
Although chronic hepatitis C follows a similar course regardless to the genotype of the infecting depending on viral genotype.
RISK FACTORS
Risk of hepatitis C infection is increase
• A health care worker who has been exposed to infected blood, which may happen if an infected needle pierces his/ her skin.
• Have ever injected or inhaled illicit drugs
• HIV
• Received a piercing or tattoo in an unclean environment using unsterile equipment
• Were born to a woman with a hepatitis C infection
COMPLICATIONS
Hepatitis C infection that continues over many years can cause significant complications such as,
• Scarring of the liver i.e. cirrhosis: After decade of hepatitis C infection, cirrhosis may occur. Scarring in liver makes it difficult for liver to function.
• Liver cancer: A small number of people with hepatitis C infection may develop liver cancer.
• Liver failure: Advanced cirrhosis may cause liver to stop functioning.
PREVENTION
Following steps can taken to prevent hepatitis C infection
• Stop using illicit drugs, particularly if you inject them. If you use illicit drugs, seek help.
• Be cautious about body piercing and tattooing. If you choose to undergo piercing or tattooing, look for a reputable shop. Ask questions beforehand about how the equipment is cleaned. Make sure the employees use sterile needles. If employees won’t answer your questions, look for other shop.
• Practice safe sex. Don’t engage in unprotected sex with multiple partners or with any partner whose health status is uncertain. Sexual transmission between monogamous couples may occur, but the risk is low.
Most common Hepatitis C medicines-
3MEDS, the best Hepatitis C medicine provider in India brings the best of high-quality Hepatitis C medication at the lowest price.
• A combination of Daclatasvir and Daklinza
• A combination of Elbasvir and Grazopevir
• A combination of Ledipasvir and Sofosbuvir
• A combination of glecaprevir and pibrentasvir
• A combination of sofosvir and velpatasvir
Buy medicines online at 3MEDS and get a 23% discount on genuine medicines and all healthcare products.
TREATMENT
Hepatitis C infection is treated with antiviral medications intended to clear the virus from body. The goal of treatment is to have no hepatitis C virus should be detected in body after 12 weeks of complete treatment.
Researchers have recently made significant advances in the treatment of hepatitis C using new direct acting antiviral medication, sometimes in combination with existing ones. As a result people experience better outcomes, fewer side effects and short treatment times.
Vaccination: Although there is no vaccine for hepatitis C infection, in this scenario generally vaccines of hepatitis A and B are recommended. These are separate virus that can cause liver damage and complicate the course of chronic Hepatitis C.
Lifestyle and home remedies: Stop drinking alcohol as it speeds the progression of liver disease. Avoid medications that may cause liver damage. Help prevent others from coming in contact with infected blood.
Hepatitis C price and safety advisor-
It has become a genuine problem in present because of the COVID 19 pandemic. Common are running low on money and high on problems,3MEDS online pharmacy store is the best solution of their problem. It is providing 23% offer on genuine medicines and all health care products. Order 100% genuine medicines online at 3MEDS.com and get it delivered to your door step without getting out of your home. Get delivery within 24 hours of delivery anywhere in Delhi.
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The need for continuous cost-effectiveness analysis
At drug launch, treatments have some benefit and cost. However, drug prices may change over time. Additionally, treatment benefits may rise or fall depending on how well efficacy translates into effectiveness and how well physicians learn to manage adverse events.
Mattingly and Love (2020) provide a case study of how cost-effectiveness analysis can change over time. They examine the case study of hepatitis C virus (HCV) treatments, which is well known since sofosbuvir’s “$1,000 a pill” list price sparked a lot of debate, despite broad evidence that the treatment was cost-effective. New HCV treatments later entered the market including elbasvir/grazoprevir, sofosbuvir/velpatasvir and glecaprevir/pibrentasvir. The authors then examine the cost effectiveness of the best available HCV treatment in 2010, 2012, 2014, 2016 and 2018. They find that:
No HCV treatment resulted in a gain of 11.54 QALYs over a 20-year time horizon at a cost of $42,938. Costs for treated groups were $69,075, $123,267, $125,431, $86,782, and $56,470 for the 2010, 2012, 2014, 2016, and 2018 scenarios, respectively. QALYs gained for treated groups were 12.90, 12.97, 13.34, 13.39, and 13.46 for the 2010, 2012, 2014, 2016, and 2018 scenarios, respectively. The incremental cost-effectiveness ratios in each year compared with no treatment were $19,218 per QALY, $56,104 per QALY, $45,829 per QALY, $23,699 per QALY, and $7,048 per QALY.
In short, treatments became more and more effective over time. Initially, cost rose from 2010-2014 and cost-effectivenes worsened between 2010 and 2012. However, as effiacy continued to rise and cost began to fall, cost-effectiveness improved from 2012 to 2018. Now, treatment costs are less than at launch despite new treatments adding more than 0.5 QALYs per patient.
Mattingly and Love make a compelling case that value assessment is not a one-time endeavor, but needs to be revisited as a treatment landscape evolves.
The need for continuous cost-effectiveness analysis published first on your-t1-blog-url
0 notes
Text
The need for continuous cost-effectiveness analysis
At drug launch, treatments have some benefit and cost. However, drug prices may change over time. Additionally, treatment benefits may rise or fall depending on how well efficacy translates into effectiveness and how well physicians learn to manage adverse events.
Mattingly and Love (2020) provide a case study of how cost-effectiveness analysis can change over time. They examine the case study of hepatitis C virus (HCV) treatments, which is well known since sofosbuvir’s “$1,000 a pill” list price sparked a lot of debate, despite broad evidence that the treatment was cost-effective. New HCV treatments later entered the market including elbasvir/grazoprevir, sofosbuvir/velpatasvir and glecaprevir/pibrentasvir. The authors then examine the cost effectiveness of the best available HCV treatment in 2010, 2012, 2014, 2016 and 2018. They find that:
No HCV treatment resulted in a gain of 11.54 QALYs over a 20-year time horizon at a cost of $42,938. Costs for treated groups were $69,075, $123,267, $125,431, $86,782, and $56,470 for the 2010, 2012, 2014, 2016, and 2018 scenarios, respectively. QALYs gained for treated groups were 12.90, 12.97, 13.34, 13.39, and 13.46 for the 2010, 2012, 2014, 2016, and 2018 scenarios, respectively. The incremental cost-effectiveness ratios in each year compared with no treatment were $19,218 per QALY, $56,104 per QALY, $45,829 per QALY, $23,699 per QALY, and $7,048 per QALY.
In short, treatments became more and more effective over time. Initially, cost rose from 2010-2014 and cost-effectivenes worsened between 2010 and 2012. However, as effiacy continued to rise and cost began to fall, cost-effectiveness improved from 2012 to 2018. Now, treatment costs are less than at launch despite new treatments adding more than 0.5 QALYs per patient.
Mattingly and Love make a compelling case that value assessment is not a one-time endeavor, but needs to be revisited as a treatment landscape evolves.
from Updates By Dina https://www.healthcare-economist.com/2020/06/29/the-need-for-continuous-cost-effectiveness-analysis/
0 notes
Text
The need for continuous cost-effectiveness analysis
At drug launch, treatments have some benefit and cost. However, drug prices may change over time. Additionally, treatment benefits may rise or fall depending on how well efficacy translates into effectiveness and how well physicians learn to manage adverse events.
Mattingly and Love (2020) provide a case study of how cost-effectiveness analysis can change over time. They examine the case study of hepatitis C virus (HCV) treatments, which is well known since sofosbuvir’s “$1,000 a pill” list price sparked a lot of debate, despite broad evidence that the treatment was cost-effective. New HCV treatments later entered the market including elbasvir/grazoprevir, sofosbuvir/velpatasvir and glecaprevir/pibrentasvir. The authors then examine the cost effectiveness of the best available HCV treatment in 2010, 2012, 2014, 2016 and 2018. They find that:
No HCV treatment resulted in a gain of 11.54 QALYs over a 20-year time horizon at a cost of $42,938. Costs for treated groups were $69,075, $123,267, $125,431, $86,782, and $56,470 for the 2010, 2012, 2014, 2016, and 2018 scenarios, respectively. QALYs gained for treated groups were 12.90, 12.97, 13.34, 13.39, and 13.46 for the 2010, 2012, 2014, 2016, and 2018 scenarios, respectively. The incremental cost-effectiveness ratios in each year compared with no treatment were $19,218 per QALY, $56,104 per QALY, $45,829 per QALY, $23,699 per QALY, and $7,048 per QALY.
In short, treatments became more and more effective over time. Initially, cost rose from 2010-2014 and cost-effectivenes worsened between 2010 and 2012. However, as effiacy continued to rise and cost began to fall, cost-effectiveness improved from 2012 to 2018. Now, treatment costs are less than at launch despite new treatments adding more than 0.5 QALYs per patient.
Mattingly and Love make a compelling case that value assessment is not a one-time endeavor, but needs to be revisited as a treatment landscape evolves.
The need for continuous cost-effectiveness analysis posted first on https://carilloncitydental.blogspot.com
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