Beyond the Hype: What Sofosbuvir Means - and Doesn't - for Global Hepatitis C Treatment

In December 2013, authorities in the United States and Europe approved Gilead's highly anticipated hepatitis C drug, sofosbuvir. This drug and other new treatments for hepatitis C, called direct-acting antivirals (DAAs), have created a buzz among medical and research communities, patients, and financial analysts. Taken in pill form rather than by injection, and with cure rates and side-effect profiles better than previously seen for hepatitis C, many are hailing sofosbuvir and other new oral medicines as "miracle cures." The new drugs, however, come with a major limitation -- price. Business analysts currently estimate that Gilead could charge $80,000 USD for a single course of treatment of sofosbuvir. With nearly 90 percent of the estimated 185 million people living with hepatitis C worldwide residing in low- and middle-income countries, where government health budgets are small and where most patients have to pay for medicines out of pocket, this price tag means that sofosbuvir and the other new hepatitis C medicines will remain out of reach for the majority of those in need. In this new report, we examine the new hepatitis C treatment market and projected revenues, and look back at what we can learn from the fight for access to HIV medicines in the 2000s to help secure reductions in the price of these promising new hepatitis C treatments

Hepatitis C Treatment: Price, Profits, and Barriers to Access

The World Health Organization estimates that as many as 185 million people, or 3 percent of the world's population, are infected with the hepatitis C virus. Though it is curable, the vast majority of people living with hepatitis C reside in low- and middle-income countries where treatment is virtually inaccessible.The main medicine used in the current standard of care—Pegylated Interferon-alfa (Peg-IFN)—can cost as much as $18,000 USD in these countries for a 48-week course of treatment. For those who cannot afford it, this price tag may mean death.In this new report, Hepatitis C Treatment: Price, Profits, and Barriers to Access, we examine the difference in price of a 48-week course of hepatitis C treatment in low- and middle-income countries, and detail breakthroughs that have been made in countries like Egypt and Thailand to negotiate lower prices and increase access to this lifesaving medicine

The effects of an art education program on competencies, coping, and well-being in outpatients with cancer—Results of a prospective feasibility study

The aim of this study was to develop an art education program for ambulatory patients with cancer and to assess its feasibility and possible effects We conducted the workshops an groups of 4-8 participants A total of 23 participants completed the entire art education program Six patients dropped out but neither of them dropped out because of program length Some changes to the program were made after receiving feedback from the participants and the program length was augmented from 20 to 22 sessions Anxiety and self-confidence improved during the course of the program whereas coping and depression did not change Results suggest that art education workshops with outpatients are feasible but recruitment may be difficult especially at the beginning Based on the characteristics of the patients special attention should be paid to establish a high-level of structure to the sessions in order to provide the participants with enough safety for self-exploration and expression The creation of an object e g a book may help in this prospect as well (C) 2010 Elsevier Inc All rights reserve

Patients' acceptance and psychometric properties of the EORTC QLQ-CX24 after surgery.

OBJECTIVE: The aim of this study was to evaluate patients' acceptance and the reliability and validity of a recently developed instrument to assess quality of life among cervical cancer patients, the European Organization for Research and Treatment of Cancer Cervical Cancer Module (EORTC QLQ-CX24), in surgically treated patients after primary surgery. METHODS: The EORTC QLQ-CX24 was administered to 134 cervical cancer patients who had undergone pelvic surgery. Additional questionnaires completed were the EORTC QLQ-C30, and the Hospital Anxiety and Depression Scale. Sociodemographic and medical data were recorded. RESULTS: Missing values occurred in 4.5% of all non-optional items. Internal consistencies (Cronbach's alpha coefficients) for the three multi-item scales ranged from 0.70 to 0.87 (Symptom Experience 0.70, Body Image 0.87, Sexual/Vaginal Functioning 0.76), whereas scaling errors occurred in 6.8%, 0.0%, and 6.3% of the cases. In all domains, the entire range of the scale was used by patients. The scales were able to discriminate between different subgroups of patients. CONCLUSION: These psychometric analyses confirm that the EORTC QLQ-CX24 is a useful tool for the assessment of quality of life in cervical cancer patients after surgery

Human rights and access to hepatitis C treatment for people who inject drugs.

BACKGROUND: People who inject drugs (PWID) achieve adherence to and outcomes from hepatitis C virus (HCV) treatment comparable to other patients. Nonetheless, this population has been excluded from treatment by regulation or practice. Approval of safer and more effective oral HCV medicines should offer greater treatment options for PWID, although high medicine prices have led to continued treatment rationing and exclusion in developed countries. In middle-income countries (MICS), treatment is largely unavailable and unaffordable for most PWID. METHODS: Human rights analysis, with its emphasis on the universal and interconnected nature of the economic, social and political spheres, offers a useful framework for HCV treatment reform. Using peer-reviewed and grey literature, as well as community case reports, we discuss barriers to treatment, correlate these barriers to rights violations, and highlight examples of community advocacy to increase treatment for PWID. RESULTS: Structural drivers of lack of treatment access for PWID include stigma in health settings; drug use status as a criterion for treatment exclusion; requirements for fees or registration by name as a drug user prior to treatment initiation; and incarceration/detention in prisons and rehabilitation centers where treatment is unavailable. High medicine prices force further exclusion of PWID, with cost containment masked as concern about treatment adherence. These barriers correlate to multiple rights violations, including of the rights to privacy; non-discrimination; health; freedom of information; fair trial; and freedom from cruel, inhuman and degrading treatment. CONCLUSIONS: Needed reforms include decriminalization of drug use, possession of drugs and drug injecting equipment; removal of exclusionary or discriminatory treatment protocols; approaches to strengthen links between health providers and increase participation of PWID in treatment design and implementation; and measures to increase transparency in government/pharmaceutical company negotiations and reduce treatment price

Digital Object Characterization: Document Conversion and Qualiity Assurance

Whether we are migrating document formats to achieve interoperability or ensure long term preservation, we are faced with the issue of assessing the quality of the digital object transformation. However, comparing two digital objects is not straightforward. It raises the issue of properties that are inherent to the digital objects and those that are dependent on the environment in which the objects are created, viewed, and compared to one another. That has implications for devising methods to extract document properties, interpret observed characteristics, and apply similarity metrics. Furthermore, in order to take actions based on collected measurements, we need to define or learn the significance of individual document properties from the perspective of human perception and usage scenarios. We illustrate the complexity of these issues by presenting a method for comparing converted office documents and discussing the challenges from the technical and methodology point of view