Hep C in the Philippines

There are two big problems for people who have Hep C in the Philippines, one is the cost of the Hep C medication and the other is the stigma associated with having Hepatitis C.

In this post I would like to share the story of a young man from the Philippines who caught Hep C when he was in his teens, probably from a blood transfusion. He found out he had Hep C when he went to the doctor with extreme fatigue and pain in the area of his liver.

For the purpose of this story, I will call him Henri.

Henri’s  Hep C diagnosis was based on his symptoms and a Hepatitis C antibody test.

He is now in his 30’s and works as a laborer in the construction industry for a basic wage of less than US$50 per week. The Hep C induced fatigue makes manual labor very difficult for him but there is no social safety net in the Philippines, he must work or his family will starve.

A Hep C viral load test costs about US$120 in the Philippines whereas a HCV antibody test costs only a few dollars. Getting a viral load test is completely out of the question for Henri because he supports his family with just enough money to cover their basic needs from week to week.

The low wages and high cost of a viral load test means that very few Filipinos can afford a viral load test or genotype test. So the combination of a Hep C antibody test + symptoms is the normal route for Hep C infection diagnosis.

The Price of hep C Treatment in the Philippines

The normal cost for a 12 weeks Hep C treatment is between 35,000 pesos and 60,000 pesos, depending on which medication is used. The USA based drug company Mylan has a significant presence in the Philippines and has recently spent a lot of money in the Philippines promoting its generic Epclusa as the optimum Hep C treatment for Filipinos. The average retail price for a 12 weeks treatment with generic Epclusa is between 50,000 and 60,000 pesos (0ver US$1,000), obviously an impossible price for people like Henri.

Interestingly Mylan chose to use the Filipino movie star Michael Mesa to promote Hepatitis C treatment in the Philippines. This is nice for two reasons, firstly because Michael Mesa is one of those brave people who was open and very public about their Hepatitis C infection and subsequent treatment, secondly because I supplied Michael with the medication for his Hep C treatment about 4 years ago.

Here is Henri’s story:

Hepatitis C in the Philippines

Good evening sir i am a filpino and im positive of hepatitis c since 2017…i dont know what to do sir..i am a poor person i have no money to undergo any treatment..i just wanna ask u sir if there is anyway to do how

I feel the pain in my right side sir

Im working in construction only a very low wage.

Help me sir..i cannot afford to undergo the treatment.

As of now sir i have no medicines to maintain health, I can not afford even vitamins..because i am the only one who supports my mother and brother.

Sir Greg, thank you for all your help. I’m sorry if I had to ask you about my medication for my illness. You see, when my relatives knew that I have hepa C, all of my relatives rejected me. They loathe me because I have hepa C. And I cannot afford all medication needed because I only work in the construction company.

(Because Henri’s doctor had diagnosed Hepatitis C based only on the Hepatitis C antibody test, to confirm he had Hep C I suggested that he take a liver function test. If he is positive for Hep C antibodies, and has elevated liver enzymes, and has Hep C symptoms then it can be safely assumed that he has Hep C. The elevated liver enzymes also give a pre-treatment baseline for people who can not afford the post-treatment SVR 12 viral load test)

Ok sir then what is the next step i make after the liver test..

If a person cannot afford a Hep C viral load test, a Hep C antibody test + a liver function test is a useful Hep C diagnosis tool.

Philippine Liver Function Test

Henri’s liver function test results showed elevated liver enzymes; his ALT was 252 (about 4 times higher than normal). His AST was 118 ( three times higher than normal). Henri also had elevated protein levels, elevated Globulin, elevated Bilirubin and a GGT level of 215 (about 4 times the normal level).

Combined with a positive Hepatitis C antibody  test and having Hep C type symptoms it is almost 100% certain that Henri has Hep C.

Affordable Hepatitis C Treatment in the Philippines

So the next thing was to get him treatment. Fortunately, I had recently negotiated a bulk purchase of Sofosbuvir + Daclatasvir from an Indian manufacturer at prices that enable me to supply a 12 weeks treatment for 15,000 pesos, including shipping to the Philippines by registered airmail.

Unfortunately, that amount was still beyond Henri’s reach. He has no disposable income. Every peso he earns goes to meeting the basic needs of himself and his family.

In the Philippines, people overcome these financial problems by asking friends and relatives for help in the form of a loan, however because Henri had been cast out by his family this option was not available.

In such situations, I have a small fund of donations I can draw upon to supply Hep C medicines at a price that can be afforded by people in such impoverished situations.  So I talked through things with Henri to find out an amount he could manage and we reached an agreement that enabled him to start treatment immediately.

As I sit here writing this Henri’s medication is on the way to the Philippines and I expect Henri to receive his medication in the first week of the New Year. Hopefully, the treatment will immediately improve his energy levels and enable him to manage the hard work of laboring on a construction site.

 

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