Bloomberg News reported that many state-run Medicaid programs limited the use of Gilead Sciences’ hepatitis C treatment Sovaldi because the drug costs $1,000 per day for a 12-week treatment course. Pennsylvania and Colorado would limit Sovaldi to the sickest patients. Louisiana, California, Michigan, and Florida would approve Sovaldi for Medicaid patients on a case-by-case basis. WellPoint Inc., which managed Medicaid claims for 4.4 million people in 19 states, would okay a combination therapy of Sovaldi and Olysio only for people with liver damage.
CDC reported that hepatitis C-infected people in the United States were more likely to be black, to have less than a high school education, and to have an average annual income of less than $23,000. Although CDC recommends hepatitis C screening for all US residents born between 1945 and 1965, hepatitis C-infected people on Medicaid were unlikely to get the best treatment before the virus had damaged their livers. The 2010 Patient Protection and Affordable Care Act would make approximately 12 million additional people eligible for Medicaid.
While the United States spent $260 billion annually for all drugs, the cost of treating every hepatitis C-infected person in the United States with list price Sovaldi would be $227 billion. Gilead justified the high US price because treatment prevented future complications such as liver cancer, which could require a liver transplant. Although other approved hepatitis C treatments such as Victrelis cost less than half as much as Sovaldi, these older drugs had lower cure rates and unpleasant side effects.
Gilead might sell a 12-week course of Sovaldi to India for $2,000 because Gilead tailored the price to the country’s ability to pay. Gregg Alton, Gilead’s executive vice president of corporate and medical affairs, believed that the older, less expensive therapies were not tolerable and would not prevent future complications.
Infection Control Today reported that a recent statement by leading health organizations read that a continued research investment for new vaccines is crucial to curbing the spread of sexually transmitted infections (STIs). The statement in the special issue of the journal Vaccine was co-edited by the US National Institutes of Health’s National Institute of Allergy and Infectious Diseases and the World Health Organization (WHO).
It is estimated that more than 500 million STIs, which cause a variety of health and reproductive problems, are transmitted globally each year. Many STIs have become increasingly hard to treat, especially gonorrhea, which is now resistant to many antibiotics.
“Sexually transmitted infections are a massive health challenge,” says Dr. Marleen Temmerman, director of the Department of Reproductive Health and Research at WHO. “First, they are extremely common—more than a million new infections occur every day. Second, most infections don’t show any symptoms so people don’t know they are infected. Third, gonorrhea, one of the major diseases, is becoming increasingly resistant to the medicines currently available to treat it.”
Many countries have programs concentrating on promoting healthy sexual behaviors. Although the developed world has access to accurate STI tests, some countries are limited in their testing and treatment capabilities due to various factors, including financial and geographic challenges. Another major challenge is that many people do not have symptoms and, therefore, transmit STIs unknowingly to others. Sexual health experts agree that widespread immunization could “revolutionize” the treatment of STIs worldwide.
The full report, “Toward Global Prevention of Sexually Transmitted Infections (STIs): The Need for STI Vaccines,” was published in the journal Vaccine (2014; 32 (14): 1527–1535).
NewScientist reported on the creation of a new contraceptive device for women that also prevents HIV and herpes. Patrick Kiser of Northwestern University in Evanston, Ill., and colleagues developed a flexible vaginal ring made of a malleable tube containing tenofovir, an anti-HIV drug, and levonorgestrel, a contraceptive. Once the drugs are distributed throughout the vagina, they should maintain their efficacy for hours, giving the wearer freedom to remove the ring temporarily.
The researchers are awaiting approval to begin US trials of the ring. So far, the researchers have done animal testing, which showed that the device delivered the anti-HIV drug in similar doses as gels previously used in human trials and delivered effective levels of contraceptive. Also, in other trials, tenofovir has been proven to protect against herpes. The ring costs approximately $10, but Kiser believes the price can be lowered to $5.
According to Kiser, the use of vaginal gels before and after sex, and pills as pre-exposure prophylaxis, have failed because they were not used correctly. The researchers created the ring with the goal of providing women in developing countries a method of protecting themselves if their partner refused to wear a condom. Kiser explained that he wanted something easy for women; the user can insert the ring and forget about it for months, have sex with it in place, or remove it for short periods of time.
The full report, “Engineering a Segmented Dual-Reservoir Polyurethane Intravaginal Ring for Simultaneous Prevention of HIV Transmission and Unwanted Pregnancy,” was published online in the journal PLoS One (2014; doi: 10.1371/journal.pone.0088509).
News Talk Florida reported that the Florida Department of Health in Hillsborough County would offer free HIV, STD, and TB testing on World TB Day, March 24, from 7:30 a.m. to 3:00 p.m. at 1105 East Kennedy Boulevard in Tampa. World TB Day commemorates the day in 1882 when Dr. Robert Koch announced the discovery of the Mycobacterium tuberculosis that causes TB infections. CDC, the World Health Organization, and other premier public health organizations recognize World TB Day, which is an event to “promote TB awareness, education, testing, and prevention in order to reduce TB mortality” worldwide.
The 2014 theme for World TB Day is “Reach the Three Million.” The Stop TB Partnership stated that one-third of the 9 million people with new TB infections each year did not receive needed TB services. Most of the underserved TB patients are among the poorest, most vulnerable communities.
The Florida Department of Health’s three TB priorities are to identify and treat every active TB case until cured, to evaluate and treat active TB case contacts, and to “provide targeted testing and treatment for high-risk populations.”
See more information about the Florida Department of Health in Hillsborough County at http://www.hillscountyhealth.org/.
Fort Mill Times reported that AIDS Healthcare Foundation (AHF) recently opened its latest domestic specialized HIV/AIDS healthcare center in Maryland. The clinic is located at 4302 St. Barnabas Road, Suite B, in Temple Hills, with hours of operation from 8:30 a.m. to 5:30 p.m. on Tuesdays. Those interested in AHF’s services can contact the clinic by phone at (301) 423–1071, and by fax at (301) 423–1364. AHF’s goal is to reduce the number of new diagnoses by providing free testing, immediate linkage to care regardless of the client’s finances, and continued support to help patients adhere to the treatment program. Maryland Department of Health and Human Hygiene data reported approximately 27,710 HIV-positive adults and adolescents in the state as of December 2011. The state ranked ninth in the nation for number of AIDS cases and third among US states and territories in estimated diagnosis rates. National estimates suggest approximately 6,250 Marylanders are HIV-positive without knowing it.
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