A few days ago, I came across a news article that intrigued me. It involved the practice of performing liver transplants using donors who are infected with Hepatitis C virus. You can read the article here: Could hep-C-infected livers solve New York’s organ-donor shortage?

Right off the bat, you might think this concept would be described best as…

(Who would do such a thing?)

Up until a few years ago, you would be right. The mere idea of transplanting organs, blood, or other tissues infected with hepatitis C was considered completely unethical. After all, you would be giving a person a potentially lethal disease.

Yet, times have changed. Today, there is a treatment for this viral disease with up to 99% success rate. It’s known as…

(aka “The Cure”)

This drug is a combination of two effective means to prevent Hepatitis C from reproducing in the body. One, known as sofosbuvir prevents the virus from multiplying inside the cell. The other, velpatasvir, blocks the ability to assemble new viruses.

With this in mind, the concept of transplanting an infected liver becomes a little less worrisome. After all, if there’s a cure, then why not give someone a shot at living a longer life? It fulfills the human belief that…

(No one would argue with this…)

But unfortunately, there is a catch. The drug is expensive. We’re talking in the region of US$75,000 per treatment. That’s an incredible amount, particularly those without proper insurance.

Upon hearing this number, the usual approach to pharmaceuticals may come into play, which usually sounds a bit like this…

 (Remember, this is a family-friendly blog…)

But the exorbitant cost shouldn’t cause much surprise. Advanced pharmaceuticals such as this drug combination are going to be expensive. We’re not dealing with run of the mill tetracycline, which can be made for pennies a pill. The process of making these drugs is difficult and maintaining proper quality control requires far more effort. Also, Epclusa is not as pricey as other treatments offered, which can be tens of thousands of dollars higher. So, according to its manufacturer, this drug is a bit of a deal in comparison.

I understand this may seem like a defense of the pharmaceutical industry and that for the sake of public opinion you might suggest…

(Which is usually good advice…)

But when dealing with a serious topic such as transplantation, in which the end result is either life or death, the issue of what is the right cost for a drug becomes secondary to the situation at hand.

I do think the amount is too high. Yet this is the reality as we face it. It’s not what most people – other than perhaps stockholders of the company – would like to hear but as we’ve learned in many health-related issues, we have to…

(It never gets easy…)

Which brings me back to the article. Should we use infected livers for donation? I feel if a system in is place that allows the recipient to receive cost-effective and/or fully covered treatment, it may help to lower the burden of waiting lists.

But what if a person is going to undergo the treatment and then be left to deal with figuring out how to deal with the disease? The individual may be faced with a question of prolonged life in a state of continual debt.

At this point, the decision should be left up to the person to decide which is the better option. Then, when the choice is made, we should all stand with that person and say only…

(Also, “I support you.”)

 

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