Is Interferon Done?
Recently I was made aware that interferon is still the only choice for thousands of people who are eligible to treat based on fibrosis stage criteria, but, are not able to access new Direct Acting Antivirals. In some places in our world, no treatment at all is available, regardless of fibrosis stage or illness caused by living with chronic hepatitis c. In fact there is little hint of any meaningful attempts to test people to see if they are even positive for HCV, never mind treating them.
The news that it was the only available treatment for 30% of those who qualified where I live was a real shocker to me given what we know about the terrible side effects it causes for almost everyone with few exceptions. I can say this with a high degree of certainty even though I have no data to support this claim. Years of listening to others who have treated once, twice, or even more times with interferon, and in my own personal experience, I am comfortable in calling it toxic. If anyone has gotten through 24 or 48 weeks of treating with this drug they have my sympathy.
I won’t recall my own story here but suffice it to say it was the most difficult thing I have ever done in my life.
I am not alone in this belief.
Like many others who have been supportive of new drugs, which don’t include interferon, it is incomprehensible that it is still used.
In an era of better drugs with fewer side effects and shorter durations why would we still see it being used?
Some have suggested price was the determinant, and there is a study which indicates it is still effective with a comment about how it was “well tolerated”. I suggest those people who are promoting this view should be made to take injections for a month or two themselves.
In my opinion there is no doubt about how the insurers/payers want to contain costs, and I will not go down that road here now, along with any number of reasons why we cannot treat people. Capacity to treat is one I read and hear often; with few actions meant to change the situation with too few experienced treating physicians available.
The strange thing is that there has always been a reason not to treat more people, whether new or old drugs. There have been efforts to justify costs by the manufacturers, who cite how effective it is against older therapy, and arguably they make a good case based on the efficacy, whether you think they are greedy or not. I am convinced that the side effects are much easier to tolerate and the SVR rates are much higher for most people. Researchers have shown that the cost of not treating people is not a good long-term approach, in as much as it cost more over time because of worsening disease. I read and hear a lot of good and reasoned arguments about HCV and treatment.
I may sound like I am confused and maybe I am, but what I am saying is that there have been all sorts of explanations about what and why we can or cannot treat people with the best possible care and therapies.
Back to what I chose as the topic for this piece; is Interferon done?
No is the short answer.
Who can answer this question-to my satisfaction-no, even if I have been told some reasons I mentioned here.
The final word now for me is that nobody should have to treat with this drug ever again.
This is my opinion. Like many others I have permanent damage caused by this drug and would never wish it on anyone. I repeat that it is your decision to make, with your treating physician, armed with the best information and real-life experience of others if you choose.