Public Address | Cafe | Hard News: Hep C: When doctors do the wrong thing

Hazel Heal

Fri, 07 Apr 2017 10:46:18 +1200

Update to this is, HDC have accepted my complaint and have asked the SDHB to respond to it. Since this blog this article has appeared in the Lancet on the issue of global access to hep C meds. generic in particular: http://fixhepc.com/media/kunena/attachments/391/Importation-of-generic-hepatitis-C-therapies.pdf

Hazel Heal

Sat, 04 Mar 2017 09:03:14 +1300

I would also like to say that I am sorry for (nearly) all the SDHB gastro clinicians. I can slag them off in this way and I know they have no right of reply, which is unfair. Their only right of reply is all through their Team Leader, who claims…

Rosemary McDonald

Fri, 03 Mar 2017 18:53:01 +1300

I just wish the health administrators could do it!

Brian Easton does what he does best on just that issue here.

Lilith __

Fri, 03 Mar 2017 15:28:16 +1300

It's amazing what one person or a small group of passionate people can achieve. I just wish the health administrators could do it! And that there wasn't such a gulf between public health organisations and the people they serve.

Hazel Heal

Fri, 03 Mar 2017 14:43:41 +1300

That was such a great story, isn't it Lilith-I have been thinking about it all week. See, he went to a meeting and heard people talking about generic hep C medication- he joined our groups- James Freeman's activities have had this enormous spin off too, everywhere.... this is the result…

Bart Janssen

Fri, 03 Mar 2017 13:30:00 +1300

Sadly, times have changed.

Sadly true.

Meanwhile none of that explains SDHBs behaviour, all it would take would be for them to admit they have been doing it wrong ... oh wait.

James Freeman

Fri, 03 Mar 2017 12:19:55 +1300

The real problem, and one that isn't being fixed, is the shareholder push to maximise profit.

Indeed, but it was not always so.

The chairman of the US company, Standard Oil, stated, in 1946, that the business of companies should be carried on ‘in such a way as to maintain…

Bart Janssen

Fri, 03 Mar 2017 09:27:23 +1300

I would like to add that the expensive research is no longer (in general) done by big Pharma

The cost for any drug is never the primary research, it is the cost of doing clinical trials. These are the trials developed after the thalidomide disaster. Those trials tend to cost…

Bart Janssen

Fri, 03 Mar 2017 09:24:18 +1300

Sorry I came across as saying big pharma is good and that isn't what I meant or think.

I do think the simplistic cost profit analysis for any successful drug is unreasonable.

But I also heartily agree that the big pharma model of health care is broken. Where I differ…

Worik

Fri, 03 Mar 2017 07:44:07 +1300

But for every drug that is successful there are many that fail completely and somehow these companies have to cover that cost.

Some one else replied that most drugs are not expensive to develop but are tweaks (to make it patentable again) and some one else pointed out that the…

Sacha

Fri, 03 Mar 2017 00:37:05 +1300

one can complain to the H&D Commission about services rendered but not services denied

Correct in general (and a huge problem in itself), but this seems to be about the nature of delivered services (ie: the conduct of the consultation session itself rather than any subsequent potential treatment).

If any person…

Lilith __

Fri, 03 Mar 2017 00:27:33 +1300

How awful. Individual drug researchers will have a variety of motivations, but drug companies exist to make profit, and I don’t think we can expect them to be philanthropic.
I would expect all doctors to be fighting for their patients’ health, though.

The situation has parallels in [[https://www.buzzfeed.com/patrickstrudwick/meet-the-man-who-stopped-thousands-of-people-becoming-hiv-po?|this recent Buzzfeed…

WH

Thu, 02 Mar 2017 23:10:55 +1300

The BMJ article James Freeman’s article refers to is worth reading too.

Rosemary McDonald

Thu, 02 Mar 2017 22:30:26 +1300

you can’t complain to the Health and Disability Commissioner about rudeness, but people shouldn’t come away from their doctor crying and hurt.

see Right 1 of the HDC Code: “Respect”.
Please do complain.

My understanding is that one can complain to the H&D Commission about services rendered but not services denied.…

Sacha

Thu, 02 Mar 2017 22:10:35 +1300

you can't complain to the Health and Disability Commissioner about rudeness, but people shouldn't come away from their doctor crying and hurt.

see Right 1 of the HDC Code: "Respect".
Please do complain.

Russell Brown

Thu, 02 Mar 2017 21:54:56 +1300

Wow, an example of where zone locking actually kills people. Also, “high quality” trade agreements will make this sort of work around illegal.

Indeed. Gilead priced to the market all around the world. Obviously Pharmac, as the direct negotiator, can't do the workaround, but – let's say, in a case…

Don Christie

Thu, 02 Mar 2017 21:04:04 +1300

[edit – others have made this point far more eloquently. Teach me to read from the bottom up]

But for every drug that is successful there are many that fail completely and somehow these companies have to cover that cost.

Sadly the pharma companies have got themselves into positions of…

Don Christie

Thu, 02 Mar 2017 20:55:06 +1300

Wow, an example of where zone locking actually kills people. Also, "high quality" trade agreements will make this sort of work around illegal.

Glenn Pearce

Thu, 02 Mar 2017 17:54:28 +1300

If the Hep C was contracted via blood transfusion the drugs would be funded by ACC as Treatment Injury. Ed Gane's team in Auckland help prepare these claims for patients I hope SDHB is doing the same?

Russell Brown

Thu, 02 Mar 2017 17:44:08 +1300

In other words a cure has been invented but we have made next to no impact on the disease.

I think, as Ed Gane constantly points out, that there's eminent potential to eliminate Hep C within countries like Australia and New Zealand. Countries with rampant new infection rates are gonna…

Russell Brown

Thu, 02 Mar 2017 17:41:16 +1300

But for every drug that is successful there are many that fail completely and somehow these companies have to cover that cost.

The real problem, and one that isn’t being fixed, is the shareholder push to maximise profit. If at any point a company doesn’t do that they get sued…

Bart Janssen

Thu, 02 Mar 2017 17:31:00 +1300

Yeah I edited to add that as you were typing Linger.

linger

Thu, 02 Mar 2017 17:26:25 +1300

Although, as Ben Goldacre has repeatedly noted (especially in Bad Pharma), the “but we need to fund research” argument is severely undermined by the facts that (i) drug companies spend more on (ethically dubious) advertising than on research, and (ii) most of their products are not radically new drugs requiring…

Bart Janssen

Thu, 02 Mar 2017 17:15:57 +1300

so the total ROI is now 160x funded by government and insurers.

I'm torn by this kind of stuff. Yes absolutely these companies are making huge amounts of money from successful drugs and it's really trivial to see how unfair that is on patients.

But for every drug that is…

dcrobertson01

Thu, 02 Mar 2017 17:02:07 +1300

When I lived in Cambodia, we used to get university text books printed in India for next to nothing. The publishers – O'Reilly, McGraw-Hill, No Starch Press etc used to licence the content to Indian publishers for a nominal fee, and charge people in western countries $100-150 per copy. It…

James Freeman

Thu, 02 Mar 2017 16:30:10 +1300

Dr Andrew Hill from the Chelsea and Westminster hospital and I penned an article in Liver International about the Hep C drugs and their development costs.

In short Sofosbuvir was proven up for a total sunk cost of $281 million by a NASDAQ listed company called Pharmasset and we know…

Hilary Stace

Thu, 02 Mar 2017 13:54:48 +1300

Ed Gane sounds pretty amazing. I've never met him but I have heard about his brilliance and skill from so many unrelated friends and colleagues who have.

Russell Brown

Thu, 02 Mar 2017 12:47:29 +1300

Thank you Russel, well told. At the start though, regarding Gilead's attempting to recoup it's development costs, don't worry about that- they achieved that in about the first month of sales.

Amended accordingly :-)

Hazel Heal

Thu, 02 Mar 2017 12:40:40 +1300

Thank you Russel, well told. At the start though, regarding Gilead's attempting to recoup it's development costs, don't worry about that- they achieved that in about the first month of sales. In fact, they have smashed every previous records for profit, over cost for bringing to market- unprecedented in the…

Paul Campbell

Thu, 02 Mar 2017 12:34:41 +1300

Here's the ODT's article on the issue from late last year

https://www.odt.co.nz/news/dunedin/health/sdhb-slated-hep-c-stand

Public Address

Thu, 02 Mar 2017 12:34:41 +1300

Discussion from blog post.