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Why I Do This

          

    It´s kind of been a whirlwind of thoughts and feelings since I gotten to the first project that I’ve been assigned to fly into. I´ve had to change my perspective on my goals and objectives here in this project and my time overall with MSF. I was assigned to improve the HIV/TB program in each of the projects I visit, but along with that, I have also been making myself helpful by working in the pediatric wards, which has been taking up the majority of my day.               The town is called Kalolele, there are no major roads to get here, and it is only accessible via helicopter or airplane. There are no vehicles in sight, only motorbikes. There is a road supposedly that one can use through motorbikes that would take one back to the capital, but it is rarely used and expensive. Kalole is a very young place, I’ve read in a project briefing that the median age here is about 19 years old. The majority of hospital admissions are children, which is why I am always in the pediatric wards in the usual morning. I feel like I’ve assimilated well in their medical team here and I look forward to helping and rounding with the local doctors. I´ve seen some difficult tropical medicine cases, such as cerebral malaria and many vaccine-preventable cases such as tetanus and measles. I have gotten a handful of new TB related cases every week, pulmonary and extrapulmonary TB. The majority of extrapulmonary TB I have seen are TB lymphadenopathy cases and one probable peritoneal TB case.               As for HIV, I am seeing a new diagnosis at least every two to three days. They have usually been in children, a few very young children below the age of two, usually presenting for fevers and having a positive malaria test, but due to their malnourish state, get tested for HIV. It made me more alert to re-present the guidelines for MSF to prevent mother to child transmission of HIV, which I will be presenting with one of the local nurses next week Tuesday. The local HIV nurse in charge of their program is great; she is hungry for knowledge, capable and tries to be as organized as she can in this kind of setting. Mind you though, there is no Wifi in the hospital and all of her records are hand-written which can be very tedious work. We´ve also made it a habit almost every weekday to meet at 4 PM to discuss an HIV/TB topic and talk about it so that she learns something new.               There is one case that I´ve been thinking about and is a constant reminder for me why I should and will always make the time to work in these settings in the future. There was a 15-year-old boy presenting about 10 days ago for a large swollen abdomen. Family says that his belly has been gradually getting bigger for the past 1 year, parents have tried traditional local medicine with no relief. They come from a town about 2 hours away using motorbike. On presentation the boy is in moderate distress, emaciated and appears about 10 years older than his stated age. Due to the high prevalence of tuberculosis in this setting, our first instinct as a team was to discuss the probability of TB-related peritoneal/abdominal disease. My first project in South Sudan had quite a number of these cases as the people living in that region drink unpasteurized milk, so Mycobacterium Bovis infection was quite common, and the presentation was very similar. Cases that I have seen responded well to anti-tuberculosis medication, so we started him on them right away.              

For all patients presenting with TB symptoms, we also run a panel of other tests, which includes the rapid antigen/antibody test for HIV and the antibody tests for both Hepatitis C and hepatitis B. To our surprise, the hepatitis C antibody test was positive. The viral hepatitis diseases are very difficult to treat at this level in the Congo. MSF, despite all the good that it aims to do for the people it wants to help, does usually have a narrow scope of aid. Treatment for Hepatitis B could be started, but Hepatitis C is a completely different story. Due to the lack of (financial) interest by pharmaceutical companies to make Hepatitis C treatment more accessible to all people, this child will likely die from liver failure secondary to hepatitis C. Now, I have no way of confirming whether this patient does have active disease or not; the hepatitis C test that I have been given to use does not confirm active disease, it just says whether the person has been exposed to Hepatitis C or not. In fact, there is a chunk of patients that will clear the virus on their own. But, if he does have active disease and the cause of his abdominal swelling (or ascites) is hepatitis C due to the liver starting to fail, he will eventually die from the disease.               This family has no means to go to the capital and seek treatment. The best we could do for this child is continue the course of TB medication, as long as can he tolerate it, treat his symptoms related to Hepatitis C with diuretics and paracenteses (abdominal puncture to let out fluid). He will be sent home this upcoming Monday with follow up at the local Ministry of Health clinic by his home. Him and his family were thankful for our help and services, but we emphasized as a team that his symptoms may continue to come back and that it may not be curable at this level. It´s very difficult to communicate this kind of news considering that this is my first French speaking project and that this family only speaks Swahili so all communication had to be dealt with a translator. Despite this saddening news, he was excited to go home and asked when he can go back to school.               It´s these kinds of cases and people that I have met in my life that leave a kind of thorn hanging on my side. It makes me uncomfortable thinking that we live in a world so capable to accepting this kind of injustice. Having a growing son and a family now, I want the best. I want my son to grow up, go to a nice school, become educated and live a life of relative comfort, but, its theses kinds of cases and situations that leaves a sense of discomfort thinking about that. It´s not like I shouldn´t want that for him either, its just that, this is the kind of world that we live in.               It´s all a roll of the dice.               It´s the luck of the draw.               It´s an unfortunate truth.               I want my son to somehow realize this as well. I want him to see that what he has, others do not have and that this life is only worth living if we can find a way to try to right these wrongs. I shouldn´t have to accept that this 15-year-old boy will die here in the Democratic Republic of Congo, but if he were to be in my family, if he were my son, he would live and reach his potential in the United States.                 But… this is why I do this.               This is why I am here.               I choose to see this.

[mcatmemoranda]

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Ledipasvir & Sofosbuvir combind combination is used to treat long lasting HEPATITIS C. Ledipasvir & Sofosbuvir combination is used to treat Adults and Children above 3 years of age, those who are suffering with CHRONIC HEPATITIS C.Ledipasvir & Sofosbuvir combination medications is also useful to those patients who are undergoing LIVER TRANSPLANTATION. The combination of two antiviral medicines (Ledipasvir & sofosbuvir ) workes by sloweing the amount of HEPATITIS C VIRUS in human body and over a period of tiome HEPATITIS C VIRUS completely exit the human body and improves the immune systum of the body.

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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.

Read more - 

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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Harvoni combines ledipasvir, an HCV NS5A inhibitor, and sofosbuvir, an HCV NS5B polymerase inhibitor. It could cause your hepatitis C virus more durable to treatment with anti-viral medicines . If you could have a hepatitis B infection, using sofosbuvir and velpatasvir may trigger the virus to become more lively and won't assist your EPCLUSA remedy at all or it could cause demise. Test all sufferers for proof of current or prior hepatitis B virus infection before initiating remedy with sofosbuvir / velpatasvir. HBV reactivation has been reported in HCV/HBV coinfected patients who have been undergoing or had accomplished therapy with HCV direct appearing antivirals and weren't receiving HBV antiviral therapy. Some circumstances have resulted in fulminant hepatitis, hepatic failure, and death. mavyret generic

Founded in 2018, Asegua Therapeutics LLC is committed to providing larger access to therapies. Asegua Therapeutics LLC has launched a licensed generic of EPCLUSA® (sofosbuvir/velpatasvir) and an authorized generic of HARVONI® (ledipasvir/sofosbuvir). There are not any enough, nicely-managed studies in pregnant women who've taken Epclusa without ribavirin. Epclusa must be used during being pregnant only if the potential benefit justifies the potential danger to the fetus.

Monitor HCV/HBV coinfected patients for hepatitis flare or HBV reactivation during HCV therapy and submit-remedy comply with-up. Initiate acceptable affected person administration for HBV an infection as clinically indicated. Similar data had been used to assist dosing recommendations for pediatric topics with HCV genotype 1, 2, 3, 4, 5 or 6 an infection who have extreme cirrhosis. Sofosbuvir/velpatasvir in combination with ribavirin is indicated for the therapy of kids six years and older or weighing a minimum of 37 kilos with severe cirrhosis. Sofosbuvir/velpatasvir, bought under the model name Epclusa among others, is a hard and fast-dose mixture medication for the treatment of hepatitis C in adults. It is greater than 90% effective for hepatitis C genotypes one via six. It also works for hepatitis C in those who even have cirrhosis or HIV/AIDS.

Tell your doctor about all your present medicines and any drugs you start or stop utilizing. If you have ever had hepatitis B, utilizing sofosbuvir and velpatasvir may cause this virus to become active or get worse. You might have frequent liver operate checks while using this medicine and for a number of months after you stop. In one aspect, the method contains administering to the topic an interferon-free therapy routine comprising an effective amount of GS-7977 and an efficient quantity of ribavirin. In a specific aspect, the method is sufficient to provide an undetectable quantity of HCV RNA in the topic for at least 12 weeks after the tip of the time interval. During pregnancy, this medication ought to be used solely when clearly needed. Sofosbuvir/velpatasvir, together with ribavirin, must not be used during being pregnant by both the pregnant lady or her male associate.

A licensed pharmacist is aware of how so you better ask for advice from them on the way to properly dispose of EPCLUSA. If vomiting happens within 3 hrs after taking EPCLUSA, take one other dose. If it is already longer than 3 hrs since you could have taken the first one, then don't take another pill of EPCLUSA. Just proceed with the conventional dosage and circulate of your therapy. In case you are taking Ribavirin additionally whereas under EPCLUSA prescription, then there is a treatment guide you should follow from your well being professional, and that includes how many doses you ought to be taking. The data offered in this web site is for educational purposes and not meant to exchange a discussion or recommendation with a healthcare supplier.

Common unwanted side effects embrace complications, feeling drained, bother sleeping, and nausea. It has not been studied in pregnant ladies or during breastfeeding. Greater care is required in those who are also infected with hepatitis B. Sofosbuvir works by blocking the NS5B protein and velpatasvir works by blocking the NS5A protein. One tablet as soon as day by day, often for 12 weeks, with or without food.

Read the Patient Information Leaflet if obtainable from your pharmacist before you begin taking sofosbuvir/velpatasvir and every time you get a refill. It isn't known if this remedy can stop you from passing the virus to others. Do not share needles, and apply "safer sex" to lower the risk of passing the virus to others. “We count on to see a positive impression on sharing Medicaid markets during the second half of 2019. One means Gilead's doing that's through state-managed Medicaid plans. When Gilead first unveiled the generics initiative, Evercore ISI analyst Umer Raffat famous the corporate’s presence in Medicaid was very low, as Mavyret takes the lion’s share.

In patients with serologic evidence of HBV an infection, monitor for scientific and laboratory signs of hepatitis flare or HBV reactivation during HCV remedy with EPCLUSA and through publish-treatment comply with-up. Hepatitis B virus reactivation has been reported in HCV/HBV coinfected patients who have been undergoing or had completed treatment with HCV direct appearing antivirals, and who weren't receiving HBV antiviral remedy. Cases have been reported in patients who're HBsAg positive and in addition in sufferers with serologic evidence of resolved HBV infection (i.e., HBsAg negative and anti-HBc constructive). HBV reactivation has also been reported in patients receiving sure immunosuppressants or chemotherapeutic agents; the danger of HBV reactivation associated with therapy with HCV direct-acting antivirals may be elevated in these patients. Increases in indirect bilirubin up to three mg/dL above baseline have been noted among HIV-1/HCV coinfected subjects handled with EPCLUSA and an atazanavir/ritonavir-primarily based antiretroviral regimen. The elevated indirect bilirubin values weren't associated with scientific antagonistic occasions, and all topics completed 12 weeks of EPCLUSA without dose adjustment or remedy interruption of both EPCLUSA or HIV antiretroviral agents. In the Phase three trial with decompensated cirrhosis (ASTRAL-four), isolated, asymptomatic creatine kinase elevations larger than or equal to 10xULN were reported in 1% of subjects treated with EPCLUSA with ribavirin for 12 weeks.

LEDIPASVIR/SOFOSBUVIR is a prescription medicine used to treat adults with chronic hepatitis C genotype 1, four, 5 or 6 infection with or with out cirrhosis . In these with GT 1 and superior cirrhosis or with GT 1 or four with or with out cirrhosis who've had a liver transplant, LEDIPASVIR/SOFOSBUVIR is used with ribavirin. SOFOSBUVIR/VELPATASVIR is a prescription drugs used to deal with adults with chronic hepatitis C genotype 1, 2, 3, four, 5, or 6 infection with or with out cirrhosis . In these with superior cirrhosis , SOFOSBUVIR/VELPATASVIR is used with ribavirin.

[mcatmemoranda]

Adefovir dipivoxil treats HBV. Tenofovir disoproxil treats both HBV and HIV-1. Interferon treats HBV and HCV. Ribavirin treats HCV, RSV, Hantavirus, and Lassa virus. Ledipasvir/Sofosbuvir is Harvoni; it treats hep C.

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Packing – Bank of 28 Tabs

Strenth in mg – 400/90 mg.

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Reviews of Hepcinat LP.

It was quite a struggle for many without any doubt but people came up with their responses for the generic version of Harvoni. Dana M said, “I ordered 3 bottles of Hepcinat LP and I was very nervous about the whole process.  I received the medication through the mail and I was ecstatic. The only way possible for me to have afforded this drug was to get it from India.” 

    People all around the world are praising the product that is easily and affordably available in India. The medications are easily and punctually delivered to the doorstep. There are many who initially had no idea where to start their medications from but found their relief in Hepcinat LP. “When I was diagnosed with hepatitis C... I was scared as the health care bills were shooting up and my physician prescribed Harvoni. I felt I was in a soup and the chances of survival seemed minimal. However, the healthcare staff in the hospital suggested me to find a solution. I hunted for the different meds but it was a difficult time for me,” says Ivan from Serbia.     

He adds, “Later on, I revived my search and got an eye on the Hepcinat-LP. Yes, this drug is a replica of Harvoni. This med is a savior for me. It saved my life and now I am on the way to recovery. The cost price is reduced already as the production cost is low however the affectivity is same as the original product. With each pill every day I feel relaxed and recovered. Last week after my routine blood tests were done the viral load shown were under control and I am happy about it. I would like to thank Hepcinat-LP to give me back my life. The meds are well-suited for patients like me.”

    Harvoni is always suggested primarily by all the doctors but it is not affordable to many. Hepcinat LP comes to help in such situations. Tim had a similar situation in front of him when he was diagnosed with Hepcinat LP. The Wisconsin resident said, “I was given the treatment course of Harvoni, however, the health insurance didn’t cover it so I got worried, later on, my doctor suggested to go generic version of Harvoni. My frustration level was going up to fullest than one of my friends searched on the internet and found it a solution. She said that generic Harvoni can be procured from India.”   

  He further said, “She gave me the link to the trusted online pharmacy. India has procured the licenses for the production of this drug from Gilead life sciences. So the entire process is legal and you can get the product at your doorstep without going through any hassles. I was happy to order the Hepcinat LP (generic Harvoni) from India. After two weeks of the use, the results of this antiviral drug are amazing. They are giving good results and the HBV-DNA Viral load has come to normal range.”  

   People around the world are all praising Hepcinat LP and are extremely happy with the affordable price and on time delivery of the product. Hepcinat continues to deliver comfort to Hepatitis C victims.