Filipino Doctors and Hep C Treatment

Nowadays a lot of my work is helping people in poor countries, such as the Philippines and Nigeria, to access Hepatitis C treatment. One of the barriers that I come up against is that many doctors in these countries do not understand Hepatitis C or its treatment.

Lately I have had a number of examples of doctors from poorer countries prescribing totally the wrong medication for the treatment of Hep C.

Whilst I am not a doctor I do know quite a lot about Hep C and Hep C treatment and am happy to share this information for free.

Below is an example of what I am talking about. A Filipino person has written to me asking for advice after their doctor prescribed Interferon to treat their Hep C.

Hepa C Treatment in the Philippines

To: gregjefferys@outlook.com
Subject: Inquire about Medicines for HCV

Good Day Sir Greg

My doctor prescribed medicine for my HVC, in case when I was going to buy the medicine at the Mercury Drug Store, it was said that the medicine had been theirs since 2010.

peginterferon alpha-2a

That’s the name of the medicine I prescribed.

What is the possible replacement for that?

Tagalog language (Filipino)

Good day Sir Greg

Nag- reseta po kase ang doctor ko ng gamot para sa HVC ko, kaso nung bibilihin ko na po sa Mercury Drug Store yung gamot phase out na daw po ang gamot na yung sa kanila since 2010 pa po. 

peginterferon alfa-2a

Yan po ang pangalan ng gamot na ni reseta sakin.

Ano po kaya ang pweding kapalit para jan?

My Reply

Hi Rodolfo

Unfortunately, your doctor is giving you very bad advice.

The medicine he has prescribed for you has not been used for the treatment of Hepatitis C for many years.

Peginterferon alpha-2a is not an effective treatment for Hepatitis C and also has many bad side effects.

A much better treatment is the combination of Sofosbuvir 400 mg + Daclatasvir 60 mg.

This combination of drugs is more effective than peginterferon alpha-2a and has much fewer side effects.

The cost for a 12-week treatment is 17,000 pesos including delivery.

Please let me know if you have any questions

Best wishes

Greg

Tagalog language (Filipino)

Kumusta Rodolfo

Sa kasamaang palad ang iyong doktor ay nagbibigay sa iyo ng napakasamang payo.

Ang gamot na inireseta niya para sa iyo ay hindi nagamit para sa paggamot ng Hepatitis C sa loob ng maraming taon.

Ang Peginterferon alpha-2a ay hindi isang mabisang paggamot para sa Hepatitis C at mayroon ding maraming masamang epekto.

Ang isang mas mahusay na paggamot ay ang kumbinasyon ng Sofosbuvir 400 mg + Daclatasvir 60 mg.

Ang kombinasyon ng mga gamot na ito ay mas epektibo kaysa sa peginterferon alpha-2a at may mas kaunting mga epekto.

Ang gastos para sa isang 12 linggong paggamot ay 15,000 pesos kasama na ang paghahatid.

Mangyaring ipaalam sa akin kung mayroon kang anumang mga katanungan

Pinakamahusay na pagbati

Greg

The Cost of Hepatitis C Treatment in the Philippines can vary a lot

Having Hepatitis C in the Philippines

Many people think that accessing Hep C treatment is pretty easy nowadays, and in some countries it is, but in many countries thousands of  people are dying every day from this easy to cure disease simply because they can not afford Hepatitis C treatment.

Nowadays a lot of my work revolves around helping people living in low-income situations in wealthy countries and people with low incomes in more impoverished countries such as the Philippines and Nigeria to access affordable Hepatitis C treatment.

In these countries, people with Hepatitis C face the double barriers of the high cost of medicines and the high cost of Hep C testing.

Hep C in the Philippines, the needless death of a Mother.

Recently, a few weeks ago, a young Filipino man joined our Hepatitis C support group of Facebook. He was asking about the cost of Hepatitis C medicines on behalf of his mother, who had Hepatitis C. It was explained to him that the normal cost of Hep C treatment was around US$550. At this news he was very distressed because, even with all his family contributing, there was no way that they could raise such an amount of money.

A few of our group members suggested he contact me, because I will supply Hep C treatment at my cost price to people in need.

So he contacted me but before we could discuss options is mother was admitted to hospital with liver failure and died two days later.

It was a great tragedy, his mother was only in her early 50’s and her death could have easily been prevented had her family known to contact me a few months earlier.

But in the Philippines, the cost of a medical treatment is high, beyond the reach of most Filipinos. For example genotype test is around US$200, about a total month’s wages. A Hep C viral load test in the Philippines will cost about the same, about 7,000 pesos, (about US$180).

Hepa C medication is available in the Philippines but is controlled by a corporate entity with government connections and the price of treatment is somewhere between US$800 and US$1,000, or about 4 months’ wages.

Based on WHO data the infection rate for Hepatitis C in the Philippines is a little less than 1% of the population, though data on this subject is difficult to sure of due to the heavy stigma associated with having Hep C in the Philippines.

In cases like the Philippines and Nigeria, and actually for anyone in a low-income situation anywhere, I supply Hep C meds at below my cost price. A 12 weeks treatment will cost 17,000 pesos including shipping.

To help you further understand how difficult things are for average income earners in countries like the Philippines I would like to share the some stories with you.

These were written at my request, one by a Filipino man, from Cebu, who works in the IT industry and has a reasonable wage by Filipino standards, but could not afford Hep C treatment. The other Hep C story is from a Filipina woman, also from Cebu, who was desperate to get treatment for her partner who had chronic Hepatitis C as well as liver cirrhosis and jaundice. After being bled dry by the Philippines medical services, doctors, hospitals and pathology she finally made contact with me and I was able to organise Hep C medication for her husband. Please read these Hep C stories to get an idea what is happening to the tens of millions of people with Hep C who live in the poorer nations.

Getting Hepatitis C Treatment in the Philippines

Below is the email Orville wrote to me in late 2018 asking for help with his Hep C. Following the email is the story he wrote about his journey from dying with Hep C to being completely cured.

Hi Greg,

 Good Day!

 I’m Orville and I’m From Cebu, Philippines.

 I was diagnosed with HCV around 2012 or 2013. I’ll check my results for the viral load figures, I think it was around 31 Million.

 I haven’t undergone any treatment.. I was referred by my doctor for a free treatment program, actually a trial using a new medicine. If I was lucky I would be a subject for trial of the said medicine.. However, I didn’t make it due to a large number of patients are already lined up to get the free treatment in the trial.

So all my hope of getting the treatment is gone because I can not afford the price of the Hepa C medicine.

 I’ve been looking for a support group online and Thank God I found the fb page of yours which most of the members are Pinoys.

 I’ve been very depressed about this illness and thinking when would the symptoms arise that may lead to my death. I have had an ultrasound scan that shows that my liver is enlarged and there are lesions on my liver too.

I am looking forward for your advise and suggestions for me to cope up with HCV..

 Thank you and more power.

Orville

My HCV Hopes and Expectations

By Orville John P. Caña

August 14, 2019

I am aware that once an HCV positive person dies, he/she will be cremated or be buried the soonest time possible. I already gave instructions to my wife that my body should be cremated when I pass away. My wife won’t take it seriously. My kids are also aware of my condition but I know they’re too young to absorb this fact.

A few months ago, I was browsing through the internet searching for an online support group for HCV. I found some sites but I can’t seem to find fellow Filipino members.

I tried searching on Facebook, and to my surprise, a group exists with lots of Filipino members.

In an instant, my frustrations in getting an HCV treatment turned into hope right after I joined

the Facebook group Hepatitis C Treatment and Support in the Philippines by Greg Jefferys.

 Right after a brief reading of its group description, I immediately message Greg and gained a prompt response.

I also read Greg’s blog as well as testimonies of fellow HCV patients posted on the said Facebook group which changed my life’s point of view.

It’s more than 6 years since I found out about my HCV and I’ve never been this hopeful right now.

I look forward that many more fellow HCV patients could gain access to affordable treatment through the help of Greg.

My life would be much meaningful knowing that I’d be free from the dreaded HCV virus which lurked inside me for quite some time that caused me too much worrying and depression.

Being free from the HCV virus would lead me to a much positive and healthier life.

In this way, I may live longer to be able to sustain my family’s needs especially my daughters’ education.

I couldn’t thank Greg more enough for such great help to a lot of HCV patients.

Journey towards wellness written September 2021

I was very excited when Greg told me that he had my medicines shipped already.

I started the treatment sometime in September 2019 until December.

I was not hesitant to take the medicines without a prescription since I can attest its effectiveness based on Greg’s articles and patients’ testimonies on the HCV Support group on Facebook.

Based on the article provided by Greg regarding Sofosbuvir and Daclatasvir, there may be possible side effects during treatment but fortunately, I haven’t experienced anything.

Everything just felt normal while I’m on treatment.

I believed that the treatment works and still continue to take care of myself by doing exercise, avoiding alcohol and foods that could damage the liver.

The good news

After completing my 3-month treatment period last December of 2019, I haven’t had myself tested for HCV RNA since I can’t afford it due to its 8,000php cost. Our company’s insurance is being renewed yearly and unfortunately, that time, our insurance company was different and does not cover HCV RNA testing. Because of the high price of the Hep C RNA test in the Philippines I could not afford to have the test to confirm if I was cured or not.

Thankfully around 2020, our company decided to enroll us in the same health insurance company that covers HCV RNA testing. I was not able to have myself checked immediately for Hep C RNA due to the Covid-19 pandemic that limits the movement of the people due to government restrictions.

So I waited… I felt like my Hep C had been cured but I did not know it for certain.

Another good news is when 2021 came, our company renewed the contract to the same health insurance and I took the opportunity to visit a gastroenterologist and shared everything about my HCV.

I was then referred for various laboratory tests such as HCV RNA, SGPT, Uric acid, CBC, Cholesterol, etc.

I also underwent a full abdomen ultrasound and the results were amazing. My liver is no longer enlarged and the lesions are already gone. My other organs as well were in healthy condition.

The HCV RNA result took approximately 2 weeks to arrive and I was optimistic that HCV will no longer be detected.

After several days of waiting, the result’s finally here. It did show my desired and expected result “Not Detected”.

Even though I already expected it but the feeling is unexplainable. Reading an official medical result that showed that I am free from HCV gave me relief and freed me from my long years of despair.

Thanks to the man above for making Greg an instrument to help fellow HCV patients most especially the less fortunate.

Ang aking inaasahan

A Wife’s Story

Greetings!

I would like to share my story about having Hepatitis C in the Philippines, and also, at the same time, raise awareness regarding the struggle we’ve been through trying to get Hepatitis C treatment in the Philippines. Made especially difficult during these trying times of COVID 19.

My partner is a 42-year old man from Cebu in the Philippines, he works as a collector with a basic salary of 11,000 pesos a month, that’s about US$200 per month. Of his monthly wage, we are having a net of 2,000 pesos left over at the end of each month, more or less, after rent, food and other living expenses. So at the end of the payday we have about not much left. Unfortunately, he went through the medical services here in the past year and we had to take out loans to pay for these, so we do not have much left.

Hep C Symptoms

My partner’s Hepatitis C story started last year when I noticed him that he is always feeling weak, easily got tired, he always wants to sleep,. His urine colour became a very pale light red, and his skin colour turns yellow. He usually complained about the stomach pain but the day after he’ll be feeling a little better.

Then things became worse, it was on 14th of Nov. 2020, then starts the scariest part of my life when he is again complaining about the stomach pain but this time it is severe.

He has difficulties in breathing, he can’t stand alone, and he screams a lot. My body was shaking during those times and still remember my teary eyes as I try to help him in some ways.

I was asking God please do not take him, not now my Lord! I rushed him to the nearest public hospital; There they do some lab tests and tell him to buy prescribed medicine. We spent over 15,000 pesos that one time to visit the hospital.

The High Cost of Hepatitis C in Philippines Hospitals

Then on the other day, the doctor requested an ultrasound.

Days passed, the result came. The doctor said my partner had liver cirrhosis which was too shocking for us. He said the only way to cure him is to have a liver transplant or to die.

Like, what?

How can we afford to pay for a liver transplant?

No mention about Hepatitis C or the cause of the liver problems from this doctor.

Then on 7th day of Dec. 2020 we look for another opinion this time in a liver specialist.

The Liver doctor made another set of requests for lab tests which cost 2,000 pesos and another set of medicines that cost more or less 15,000

Then we come to the third week of Dec.

At this time the liver doctor requested an HCV RNA TEST that cost 9,500 pesos and the result came to us on Jan. 15^th 2021.

Of course, we were hoping that the doctor will give us positive feedback that my partner’s liver is okay but it was a negative.

This is when we learn, finally, that my partner has Hepatitis C.  The doctor this time prescribed another set of medicine including 12 weeks of treatment with SOFOBUSVIR/LEDIPASVIR( Harvoni) @ cost of 39,000 pesos (about US$850) plus  LIVAMIN@92 pesos and NORMIX@110  pesos. We can’t afford to buy all this medicine especially the SOFOBUSVIR/LEDIPASVIR since we’re now financially unstable.

Harvoni in the Philippines will cost about US$850, more than 4 months wages for the average Filipino

Who can survive Hepatitis C

Deep inside I do have some worries that what if my partner will be dead soon.

Is he really going to leave us?

Is there a possibility he’ll be cured?

What happened next if I we aren’t able to buy those expensive medicines?

It scares me a lot…

As of now while we can’t afford to buy his meds, and let him drink turmeric tea hoping and praying it can help support his condition though I know what he really needs right now is the Sofosbuvir medicine.

Searching For Hep C Information

Meanwhile, being desperate I began to search the internet for some information or help.

I was hoping to look for a group that might answers my questions or some testimony of an individual who has HCV or a living testimony of a HCV survivor individual through SOCIAL MEDIA.

I joined the Facebook group “HEPATITIS C TREATMENT CURE AND COMMUNITY” and noticed there that Mr. GREG JEFFERYS constantly giving advice from a post. I was very curious about him and checked his FB account and found out his blog about HCV. I felt so happy that I found the right man who can answer my questions!

Now Mr. Jefferys explained to me that he will supply Hepatitis C medicines to people of the Philippines for the total price of 15,000 pesos instead of 39,000 pesos.

He also explained to me that the medicine that the specialist liver doctor prescribed for my partner was not the best option.

He explained that Sofosbuvir + Ledipasvir was only a good treatment for Hepatitis C genotype 1. Because we could not afford a genotype test we did not know the genotype of Hepatitis C.

In this case Mr. Jefferys explained to me that Sofosbuvir + Daclatasvir is a much better treatment option because it will cure all genotypes of Hepatitis C.

Now the medicines are in the mail to us and we are waiting for them to arrive in the Philippines and we hope it is not too late.

Salute to sir Greg Jefferys!

Thank you for taking time to read our story as we go forward to try to conquer this HCV!

God bless!

post script

We spent an estimated amount  of 15k money during our first visit in the public hospital including the laboratories and the medicines(Aminoleban, essentiale, vit e, K for potassium,etc.)

The whole abdomen ultrasound cost 1,500 pesos.

The specialist cost 500 pesos every visit. We already visit 4x and spent 2k already.

The medicine that the doctor prescribed includes *LIVAMIN, *ALDACTONE, *LACTULOSE, *HEPATIK, *NORMIX and the other one which I was not able to bought because it unavailable LOXEVA(don’t know if I read the right name of this).

The SOFOBUSVIR/LEDIPASVIR cost 13k/bottle of 28 pills, good only for 4 weeks treatment. My partner needs to have a 12 weeks treatment which is really impossible for us to afford that medicine as I mentioned in my first letter.

“Health is not just about what you’re eating. It’s als about what your thinking and saying”-unknown

https://www.pcp.org.ph/files/PJIM%20Vol53%20No1/The_2014_Hepatology_Society_of_the_Philippines_Consensus_Statements_on_the_Diagnosis_and_Treatment_of_Hepatitis_C.pdf

Ang aking inaasahan

Isinulat ni Orville John P. Caña

August 14, 2019

 Batid ko na kapag namatay ang isang positibong tao sa HCV, siya ay i-cremate o mailibing sa lalong madaling panahon na posible. Nagbigay na ako ng mga tagubilin sa aking asawa na ang aking katawan ay dapat na i-cremate kapag namatay ako. Ang asawa ko ay hindi ito sineryoso. Batid din ng aking mga anak ang aking kalagayan ngunit alam kong bata pa sila upang makuha ang katotohanang ito.

Ilang buwan na ang nakalilipas, nagba-browse ako sa internet na naghahanap ng isang online support group para sa HCV. May nakita akong ilang mga site ngunit tila hindi ako nakakahanap ng mga kapwa miyembro na Pilipino.

Sinubukan kong maghanap sa Facebook, at ako’y nasiyahan sa aking nakita, mayroong isang pangkat na mayroong maraming mga miyembro ng Pilipino.

Sa isang iglap, ang aking mga pagkabigo sa pagkuha ng gamut sa HCV ay naging pag-asa kaagad pagkatapos na sumali ako sa pangkat ng Facebook na Hepatitis C Paggamot at Suporta sa Pilipinas ni Greg Jefferys.

Pagkatapos ng isang maikling pagbabasa ng paglalarawan ng pangkat nito, agad akong nag-message kay Greg at nakakuha ng isang agarang tugon.

Nabasa ko rin ang blog ni Greg pati na rin ang mga patotoo ng mga kapwa pasyente ng HCV na nai-post sa nasabing pangkat ng Facebook na nagbago sa pananaw ng aking buhay.

Mahigit sa 6 na taon ito mula nang nalaman ko ang tungkol sa aking HCV at nawalan na ako ng pag-asang gumaling

Inaasahan kong maraming mga kapwa mga pasyente ng HCV ang maaaring makakuha ng access sa abot-kayang paggamot sa tulong ni Greg.

Ang aking buhay ay magiging makabuluhan kapag ako ay malaya na mula sa nakakatakot na virus na HCV na lumubog sa aking katawan na nagdulot sa akin ng labis na pagkabahala at pagkalungkot.

Ang pagiging malaya sa virus ng HCV ay magdadala sa akin sa isang mas positibo at malusog na buhay. Sa ganitong paraan, maaaring mabuhay ako nang mas mahaba upang maipagtaguyod ang mga pangangailangan ng aking pamilya lalo na ang edukasyon ng aking mga anak na babae.

Hindi ko masasalamin si Greg nang sapat para sa napakaraming tulong sa maraming pasyente ng HCV.

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