Vietnam era veteran carries battle cry of hepatitis C

ATHENS – Mike Blackburn didn’t serve in Vietnam but he was a veteran of that era. He never served in combat. But his war continues to this day. And according to his doctors, his war will end soon.

Blackburn, 62, has hepatitis C virus with stage 4 liver failure. A few weeks ago he was placed on hospice with 3-6 months life expectancy. His diagnosis of hepatitis C didn’t come until Aug. 10, 2014, just six days before his 62nd birthday, when he went to the hospital with severe stomach pain.

Last year’s birthday of course is a blur for Blackburn and his wife, Pam. But he’s a self-proclaimed old country boy from Kentucky and he’s a fighter and he hasn’t given up hope.

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Goodbye to the Boys on the Bus: How the VA Cured My Hepatitis C

They were a rough-looking crew, the boys on the bus. To be fair, practically no one looks great at 5:45 in the morning, the time you have to show up at the Veteran's Administration Outpatient Clinic in Redding to catch the van to Mather Medical Center in Sacramento. I say “boys” but occasionally a woman or two joined us, all of us veterans who for a variety of reasons choose the VA for our healthcare needs, even if it means occasionally riding the short bus 200 miles to see a specialist.

Most of us kept to ourselves, perhaps because the hour was early and talk would have inevitably turned to the illness that had earned each of us our seat. Cancer, lung disease and diabetes don't make for great breakfast conversation, especially if you happen to be suffering from one of those maladies and you're on the way to the doctor to find out how long you've got to live. Hepatitis C was my illness and I've never been keen to share that information with anyone. Our silence was stoic, not uncomfortable.

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Sanders Asks VA to Break Patents on Gilead and AbbVie Hep C Drugs

The ongoing debate over the cost of prescription drugs took another twist as U.S. Sen. Bernie Sanders (I-VT.) has asked the U.S. Department of Veterans Affairs to use emergency powers to break – or override – the patents on high-priced hepatitis C medicines sold by several drug makers, including Gilead Sciences.


The prices have caused a firestorm as both public and private payers complain the treatments are straining their budgets. Sanders notes the VA stopped enrolling veterans who need treatment for hepatitis C due to budget constraints. The agency has already reallocated $400 million on hepatitis C drugs, but needs additional funding.

“I cannot think of another situation where the government-use provision [of the law that allows the VA to break the patents] should be applied,” Sanders wrote in a letter to Robert McDonald, the U.S. Department of Veterans Affairs Secretary. “Our nation’s veterans cannot, and should not, be denied treatment while drug companies rake in billions of dollars in profits.”

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The VA’s Hepatitis C Problem

Martin Dames is a highly decorated veteran of the Vietnam War. He received the Bronze Star for heroism in the combat zone and three Purple Hearts for injuries he suffered while fighting. He made it out alive, only to find out years later that those combat wounds got him infected with the hepatitis C virus (HCV), a deadly blood-borne pathogen discovered in 1989 that claims about 19,000 lives annually, a large number of them veterans. That number is growing every year.

A chronic infection in around 80 percent of cases, HCV often shows no signs of its corrosive presence until extensive liver scarring occurs after decades of infection. In some cases, the disease isn’t found until it has led to cirrhosis—advanced and potentially lethal amounts of scarring. Infection with the virus is a leading cause of liver cancer and transplants in the U.S.

Some 3.5 million Americans are infected, including an estimated 234,000 veterans. Approximately 174,000 veterans in government care have been diagnosed with hepatitis C, but an additional 50,000 are thought to carry the infection unbeknownst to them. For treatment, those veterans who know they are sick must go to the U.S. Department of Veterans Affairs (VA) and its health care services extension: the Veterans Health Administration (VHA), the largest provider of hepatitis C care in the nation. The VHA serves nearly 9 million patients at over 1,700 sites, but as Dames and many other veterans.

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The White House signals a fight on high drug prices

On Monday, the Obama administration proposed taking a major step towards bringing prices down for expensive specialty medications.

In its budget, the White House calls for Medicare's prescription drug program to negotiate on prices for "high-cost drugs" and biologics, a complex and expensive class of drugs that is just starting to get competition from generics in the United States. "The administration is is deeply concerned with the rapidly growing prices of specialty and brand name drugs," the budget reads.

The Department of Veterans Affairs and state Medicaid programs get mandated discounts on these drugs, but Medicare was forbidden by the 2003 law creating its prescription drug program to negotiate on price. For years, liberals have been pushing to give Medicare that authority, which would make the United States more like the rest of the world.

It's not clear how hard the administration will fight for this idea, but you can add this to the list of budget requests that probably aren't going anywhere. Drug companies and Republican lawmakers have regularly pushed back against the idea of price controls in Medicare Part D.

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At $594 Per Dose Gilead Sciences, Inc. (GILD) Hepatitis Drug Is Too Costly For Veterans Affairs Department

Gilead Sciences, Inc. (NASDAQ:GILD)‘s hepatitis C drug Sovaldi, which comes at a cost of $1,000 a pill, has proved to be a breakthrough that reduces treatment time to 12 weeks and at reduced risk compared to a year-long treatment option available. However, this heavily-priced therapy has raised concerns and criticisms across the U.S. by payers and consumer support groups.

To consider the impact of Sovaldi’s $84,000 12-week treatment cost, the Veterans Affairs Department provides this therapy only to the sickest patients who need it. The Department is the largest single provider of hepatitis C care in the U.S., which enabled it to negotiate more than 40% discount to the $594 per-dose price with Gilead.

VA and Hepatitis C Care

The Veterans Affairs Department added Sovaldi to its formulary in April 2014. It treated around 5,400 veterans at a cost of $370 million with Sovaldi in fiscal 2014, and has asked Congress for $1.3 billion to treat another 30,000 patients with Sovaldi and other new hepatitis C drugs.

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Hepatitis C drug costing VA, DoD millions

One of the costliest drugs on the market threatens the Veterans Affairs Department's health budget — to the point that VA, which added the medication to its formulary in April, provides it to only the sickest patients who need it.

But treating all of the 174,000 hepatitis C patients in the VA health system is cost-prohibitive. Even with the cost negotiated by VA with the company's maker, Gilead Sciences Inc. of Foster City, California — $594 per dose — treatment would run nearly $12 billion.

So VA has taken a conservative approach to providing the treatment, reserving Sovaldi and its competitor, Olysio, made by Janssen Therapeutics of Titusville, New Jersey (negotiated cost: $413 per pill), for those with advanced liver disease or needing a transplant.

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Lawmakers want investigation into VA’s botched treatment of Grand Junction veteran

DENVER — Rodger Holmes served his country in Vietnam.

After he came home to Grand Junction, his struggles with depression and alcoholism left him homeless but he entered treatment programs, worked his way back and spent the last years of his life serving his community, counseling other veterans facing demons he knew well.

He might still be doing so had the 64-year-old not gone to the VA Hospital in Grand Junction last summer to finally treat his Hepatitis C — had the hospital and the system of care he and veterans are supposedly entitled to not failed so spectacularly to serve him.

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