CatNamedShithawk

This is awesome. Thanks for doing it.

I learned some years ago that I had Hep C, and in talking to my care team initially was told that I could either wait until I was end-stage, chronic liver failure to take a run at insurance, or figure out how to come up with US$90,000 to pay for treatment.

Fast forward to six months ago. I’m going over blood work with my GP for something unrelated, and he mentions my ALT. I tell him the advice I’d received previously, and his response was slack-jawed amazement. “You need to talk with Dr. So-and-so,” he tells me, “it’s NOT like that anymore. People are getting this covered by insurance now.”

The upshot was that despite my cautious optimism it’s actually not like that anymore. I underwent an 8-week course of Mavyret, and with the combination of insurance and manufacturer-sponsored co-pay assistance the total cost to me was US$10. I’m happy to report that my viral load at 5 weeks into treatment was negative, and I’ll be going in for my 12-week work-up next month, expecting to be cured.

All of this, anyway, to ask, how is my experience in the US different to what you folks see in Thunder Bay? Is treatment easier or more difficult to obtain? Does the difference in how health care is funded make a difference in the quality and availability of care in your experience?

I have known a bunch of people who were treated with Interferon, and a few who took Harvoni. Those sides were pretty horrific, and I was worried getting ready to take Mavyret. My care team assured me that Mavyret is much better tolerated than the older treatments, but I’m always a cautious optimist.

Weeks 1-2 I was pretty tired, and I ended up with a side effect that not even the manufacturer had heard of before: medication-induced anorexia (I was so hungry, but nothing sounded good to eat, and I was hypoglycemic af after about a week of that). My docs were on point, though, and totally got me through it.

Overall, I was maybe about as run down as half a flu up until about week seven. I took naps, and didn’t have the energy to get to the gym, but I feel certain it was less terrible than any number of the alternatives. I guess that’s what it came down to: whatever it was gonna take, I didn’t want to end up with the long-term complications of untreated Hep C. The side effects of Mavyret were ultimately nothing compared to what some of my friends went through.

Direct, blood on blood contact with an infected person’s blood. That’s the route of transmission - a person has to get blood carrying the virus in their bloodstream somehow.

I’ve known people who contracted it from IV drug use where they knew exactly who it came from, and people who got it the same way who swore they never used a dirty syringe. I know more than one person who believes they contracted it from contaminated tattooing equipment. I knew a guy who’s pretty sure he got it fighting in prison.

God, right? Samesies. That was my little joke: I had to quit taking drugs and be clean eleven years to work my way up to a $1500/day pill habit.

At the beginning of month two I had a scare when I was one day out from finishing the one-month box and still hadn’t received my second box. I called the specialty pharmacy, and they were like, “Oh, yeah. Says here your insurance company declined to cover the second month because you need to get a renewed authorization.”

Long story short, despite the insurance and mail order pharmacy’s best efforts to get me fucked off, my local specialty pharmacy came in clutch. When all that dumb shit jumped off they overnighted a month of the medication ‘just to have it on hand’, and when my insurance company was flailing the pharmacist broke out a week of medication and fronted it to me until I got my shit figured out. Sitting in my truck with a $12,000 box of medication in my lap after all that I don’t mind saying I fucking lost it. It took a few minutes before I was steady enough to drive.

She made me promise to never tell anyone what she’d done, so I can’t front her off, but that pharmacist is an absolute angel. Anyone fucks with her, I’ll shoot them and then drive them to the hospital.

Zofran and hydroxyzine. Worked good, and within about four days I was able to stop taking them.

My doc was like, “Whatever we have to do to get you through this. We treat you folks like the pregnant ladies.” I said, “Lulz, okay. I’m gonna go home and tell my wife I’m something like a pregnant girl. You treat black eyes, too, right?”