June 17, 2010

We will not be silent on viral hepatitis

By Rep. Mike Honda (D-Calif.) - 06/18/10 09:05 AM ET

At a Government and Oversight Reform Committee hearing this week, I testified to the devastating and deadly impacts of an unsuspecting disease: Viral Hepatitis. The fact that I was joined by Dr. Howard Koh, Assistant Secretary for Health, and Dr. John Ward, Director of the Viral Hepatitis Program at the Center for Disease Control, underscores the importance of the issue. Government oversight is a good start to getting the American public more informed, but much more is needed, according to the Institute of Medicine's 2010 report titled "Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C".

Few realize how highly infectious viral hepatitis is. Hepatitis B is 100 times more infectious than HIV. Few realize that, left untreated, it can cause liver disease, liver cancer, and premature death decades after infection. Few realize that roughly 2 billion people worldwide have been infected with Hepatitis B; over 170 million people are chronically infected with Hepatitis C; and in this nation alone, an estimated 5.3 million people are infected with either Hepatitis B or Hepatitis C. Tragically, an average of two-thirds of those infected are unaware of their status.

It is no surprise, then, that some are calling this a silent crisis. However, we cannot afford to be silent anymore. In fact, we will not be silent any more. Why? Because our countrymen and women are dying daily, needlessly, from a disease that is entirely preventable if detected early. Each year, approximately 15,000 people die from liver cancer or liver diseases related to Hepatitis B and Hepatitis C. That's over 40 Americans dying every day, with no state or district in our nation exempt from its deadly reach.

Beyond the tragic and preventable loss of human life and its subsequent hit to our country's productivity, the costs to our country our explicitly economic as well. Without effective prevention and vaccination methods in place, chronic Hepatitis B and C is expected to cost our country at least $20 billion, in treatments alone, over the next 10 years. As a result, over the same time frame, commercial and Medicare costs will more than double. Projecting further out, over the next 20 years, total medical costs for patients with Hepatitis C infection are expected to increase more than 2.5 times from $30 billion to over $85 billion.

We must, therefore, change the way Hepatitis is diagnosed and treated. With the help of Chairman Towns and Reps Cassidy, Johnson, and Dent, I introduced the Viral Hepatitis and Liver Cancer Control and Prevention Act, H.R. 3974, which provides nearly $600 million over the next five years to treat hepatitis. Our legislation focuses federal efforts on a strategy that saves lives and makes our health system more efficient. We bring together the common concerns of the diverse viral hepatitis community to fight chronic viral hepatitis by establishing, promoting, and supporting a comprehensive prevention, research and medical management referral program. And we strengthen the ability of the Center for Disease Control to support state health departments in the prevention, immunization and surveillance efforts.

Through this legislation, and with strategic investments in public health and prevention program, billions of dollars can be saved, so too the lives of tens of thousands of people in states and cities all over American. I urge all of you to join me in supporting activities that promote early detection and education. With your help, we can sound the alarm on this silent crisis.


NVHR Launches Targeted Print Advertising Campaign Urging Swift Congressional Action on Secret Epidem

As Congress prepares to shine a spotlight this week on chronic viral hepatitis, the National Viral Hepatitis Roundtable (NVHR) today launched a new targeted print advertising campaign to urge swift action on bipartisan legislation providing federal funding for state-based screening and early intervention programs. NVHR's new advertising initiative comes in advance of a hearing Thursday, June 17, before the full House Oversight & Government Reform Committee, chaired by Chairman Ed Towns (D-NY) and Ranking Member Darrell Issa (R-Calif.). The Committee has invited testimony from a diverse panel of witnesses who will offer strategies for implementing expert recommendations made earlier this year by the Institute of Medicine (IOM).

NVHR is a coalition of more than 175 public, private, and voluntary organizations dedicated to reducing the incidence of infection, morbidity, and mortality from chronic viral hepatitis that afflicts more than 5 million Americans. http://www.nvhr.org/

"NVHR's new advertising initiative is a timely reminder to Congress, the Administration, and all stakeholders that federal action is desperately needed this year to help combat this insidious disease that affects over 5 million Americans and their loved ones," said Ms. Lorren Sandt, Chair of the National Viral Hepatitis Roundtable (NVHR) and Executive Director of Caring Ambassadors Program, based in Portland, OR. "Six months ago, the Institute of Medicine issued nearly two-dozen expert recommendations for improving the federal government's response to the viral hepatitis epidemic. The pressing challenge now before Congress and the Administration is to provide federal funding to translate the IOM report into swift and decisive action."

Under the banner of "Mission: Possible," NVHR's new advertisement highlights the IOM report and urges action on HR 3974. The advertisement also features the tagline "If Congress gets on the case now, the leading cause of liver cancer won't stand a chance."

Thursday's hearing before the House Oversight & Government Reform Committee is an important step forward in this fight. An estimated 5.3 million Americans have been infected with chronic viral hepatitis B or C - and with most unaware of their infection, millions are at risk of developing life-threatening complications, especially African Americans and Asian Americans. Without detection and treatment, chronic viral hepatitis leads to liver cancer, cirrhosis, or liver failure. In the absence of federal leadership, the research firm Milliman estimates that public and private payers' cost of treating chronic viral hepatitis C alone will more than triple by 2024 to $85 billion annually. Medicare and Medicaid would absorb a disproportionate share of these added costs.

HR 3974, "The Viral Hepatitis and Liver Cancer Control and Prevention Act," is sponsored by Representatives Mike Honda (D-Calif.), Charles Dent (R-Pa.) and 49 other House Members and would help turn the tide. The Honda-Dent legislation would increase the ability of the CDC to support state health departments in their prevention, immunization and surveillance, and referral to care efforts. Much of the Honda-Dent legislation tracks with the IOM's recommendations.

Source: National Viral Hepatitis Roundtable


A nutritional supplement for treating chronic hepatitis C: Viusid

Contact: Ye-Ru Wang

World Journal of Gastroenterology
The pathogenesis of chronic hepatitis C (CHC) is associated with severe oxidative stress and non-selective immunological disturbance that lead to necroinflammation and the progression of fibrosis. Several trials have suggested that antioxidant and immunostimulant therapies may have a beneficial effect. Two previous clinical studies have reported that the Viusid related effect on histologic features, especially fibrosis, appears to be associated with antioxidant and/or immunomodulatory properties. However, the putative mechanism of action of Viusid is unknown.

A research article to be published on June 7, 2010 in the World Journal of Gastroenterology addresses this question. The authors reported the results of a randomized double-blind and placebo-controlled study to evaluate the effect of Viusid on oxidative stress and cytokine parameters in patients with CHC who had been nonresponders to previous antiviral therapy with peginterferon plus ribavirin and infected with genotype 1.

Their results show that Viusid improves oxidative stress through reduction of lipid peroxidation products and has an immunomodulatory effect on cytokine secretion via increased production of IFN-γ and IL-10, decreased production of IL-1α, and stabilized TNF-α secretion in patients with CHC who have failed previous antiviral treatment. Thus, Viusid is an interesting strategy of treatment for those patients who don't eradicate their viral infection or when antiviral treatment is contraindicated (decompensated cirrhosis). The administration of Viusid was well tolerated. Further studies are needed to evaluate the clinical impact of the administration of Viusid in patients with end-stage liver disease secondary to CHC.


Reference: Gomez EV, Perez YM, Sanchez HV, Forment GR, Soler EA, Bertot LC, Garcia AY, del Rosario Abreu Vazquez M, Fabian LG. Antioxidant and immunomodulatory effects of Viusid in patients with chronic hepatitis C. World J Gastroenterol 2010; 16(21): 2638-2647 http://www.wjgnet.com/1007-9327/full/v16/i21/2638.htm

Correspondence to: Dr. Eduardo Vilar Gomez, PhD, Associated Professor, Department of Hepatology, National Institute of Gastroenterology, 25th Avenue, 503, Vedado, Havana 10400, Cuba. vilar@infomed.sld.cu

Telephone: +53-7-8325067 Fax: +53-7-8333253

About World Journal of Gastroenterology

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2008 IF: 2.081. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.


One Year After the Launch of Telaprevir and Boceprevir, Surveyed Physicians Expect to Prescribe Triple Therapy Regimens to 90 Percent of Their Hepatitis C Virus Patients

press release
June 17, 2010, 9:00 a.m. EDT

Twenty-Five Percent of Surveyed MCOs Expect to Add Both Telaprevir and Boceprevir to Their Formularies, According to a New Report from Decision Resources

WALTHAM, Mass., June 17, 2010 /PRNewswire via COMTEX/ -- Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that, based on clinical profiles provided to them, surveyed clinicians estimate that one year after the launch of Vertex Pharmaceuticals/Johnson & Johnson/Mitsubishi Tanabe Pharma's telaprevir and Merck's boceprevir, at least 90 percent of hepatitis C virus (HCV) patients will be treated with triple therapy regimens.

The new Physician & Payer Forum report entitled Hepatitis C: Reimbursement and Uptake of Novel Antivirals Among Payers and Prescribers finds that surveyed physicians expect to treat 71 percent of treatment-naive and 78 percent of nonresponder patients with telaprevir/peg-IFN/ribavirin and 19 percent of treatment-naive and nonresponders with boceprevir/peg-IFN/ribavirin. Similar to clinicians, managed care organizations' (MCO) pharmacy directors are open to reimbursing telaprevir and boceprevir. However, surveyed pharmacy directors do not indicate a clear preference for either one of these protease inhibitors.

"Only 10 percent of the pharmacy directors we surveyed do not expect to add telaprevir or boceprevir to their drug formularies," said Decision Resources Analyst Alexandra Makarova, M.D. Ph.D. "The remaining surveyed pharmacy directors are split regarding the choice of the protease inhibitor for addition to their formularies. Twenty-five percent expect to add both telaprevir and boceprevir, while 15 percent will add only telaprevir and 5 percent will add only boceprevir. Forty percent of pharmacy directors will make their choice based on the relative cost of each agent."

The report also finds that almost half of surveyed clinicians indicate that they will use Roche's Pegasys and Merck's PegIntron interchangeably in combination with an HCV-specific antiviral agent even if this agent was evaluated in clinical trials involving only one of these peg-IFNs. However, one-third of doctors expect to combine a novel HCV-specific antiviral agent only with the peg-IFN that was used with the antiviral agent in clinical trials. These physicians indicate that they will likely use Pegasys in triple therapy regimens as the majority of HCV-specific antiviral agents are being evaluated with Pegasys rather than PegIntron.

Hepatitis C: Reimbursement and Uptake of Novel Antivirals Among Payers and Prescribers is based on a U.S. survey of 74 gastroenterologists, 26 hepatologists and 20 MCO pharmacy directors. Their responses were compared to assess similarities and differences of opinion regarding clinical, economic and scientific factors.

About Decision Resources

Decision Resources (www.decisionresources.com ) is a world leader in market research publications, advisory services and consulting designed to help clients shape strategy, allocate resources and master their chosen markets. Decision Resources is a Decision Resources, Inc. company.

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