HEPATITIS C TRETMAN U SRBIJI.

Tokom proteklih tri godine pomagao sam ljudima iz Srbije da dobiju tretman za hepatitis c ,iz razloga sto je  situacija u toj zemlji takva  da je obolelim od hepatitisa c skoro nemoguce da dodju do odgovarajuceg tretmana.Situacija u Srbiji je verovatno najkomplikovanija u Evropi uzrokovano siromastvom kao i blokadom vlade.Srbija je jedna od svega nekoliko zemalja sveta koje jos uvek nude svojim gradjanima obolelim od hepatitisa c .neadekvatnu i opasnu po zdravlje terapiju PEG intergeron+ribavirin,kao jedinu opciju.Osim ovog nedostatka pristupa tretmanu unutar Zdravstvenog  sistema,Vlada aktivno i agresivno blokira uvoz mnogo efikasnijeg i primenljivijeg HCV tretmana u Srbiju.Dakle ovo kreira dvostruku tragediju za obolele u toj zemlji,gde oni nemaju pristup tretmanu unutar zdravstvenog sistema ,jel ga vlada ne.moze priustiti a u isto vreme ne dozvoljava da se uveze o svom trosku.Ovo je rezultiralo crnim trzistem u Srbiji kontrolisanim od kriminalnih grupa ,koje naplacuju ocajnim ljudima ogromne iznose za genericje lekove.Cena od preko 2000 dolara uobicajena je za lekove koji kostaju ispod 1000 dolara.Prosecna plata u Srbiji je veoma mala pa je mnogima 2000 dolara skoro godisnja zarada.A ustedeti toliko skoro nemoguce za vecinu obolelih od hepatitisa c ,pa su prinudjeni da pozajmljuju novac.Licno poznajem ljude koji su morali da prodaju svoje kuce da bi kupili tretman.Pre nego sto predjem na opcije zelim da objasnim Medjunarodni zakon u vezi recepta za lekove koji otavra mnoge mogucnosti.Ovaj zakon dozvoljava da se preko granica prelazi sa receptom druge drzave za lekove za licnu upotrebu,maksimalno 12 nedelja lekiva za prenos.Ovo se tice svih prepisanih lekova osim onih koji sadrze opijate i halucinogene supstance.To znaci da ljudi sa HCV mogu otputovati u druge drzave i kupiti lekove.Takodje bi trebalo naglasiti zasto gradajni Srbije ne mogu uvesti genericki tretman direktno iz Indije ?Zato sto carina Srbije crvenom zastavicom obelezava posiljke iz odredjenih zemalja ,kao sto je Indija ili Egipat,pa posiljke iz tih zemalja podlezu podrobnijoj kontroli nego one iz zemalja Evrope.Ako otkriju da posiljka sadrzi HCV lekove posiljka ce biti zaplenjena i unistena ili vracena u Indiju.Dakle sta su opcije za obolele ljude iz Srbije?

Opcija 1.

Ako imate rodjake ili prijatelje ubdrzavi koja dozvoljava uvoz leka za licnu upotrebu iz Indije onda je prosta opcija da se lek posalje na.njihovu adresu odete u posetu i lek donesete sa sobom .Mnoge zemlje Evrope ne zahtevaju recept ilibdrugu dokumentaciju za uvoz lekova,u te zemlje spadaju Velika Britanija,Poljska,Estonija,Rusija….pa ako imate rodjake ili prijatelje ubrim zemljama  jednostavno i potpuno legalno mozete da odete po lekove za 12 nedeljnu terapiju i vratite se u Srbiju .Ovu opciju sam cesto organizovao.

Opcija 2

Otputovati u neku od navedenih zemalja na privremenu adresu ,hotel ,motel,aerodromski smestaj,na koju ce vam se poslati lekovi.Obicno je vreme dostave veoma predvidivo pa mozete cekati 3 do 4 dana dok stignu.Naravno ova opcija ima troskove puta i smestaja.

Opcija 3.

Otici direktno u zemlju koja proizvodi genericke lekove kupiti ih i vratiti se u SrbijuU ovom slucaju potrebno je naci doktora u toj zemlji koji ce vam.prepisati recept.Da bi olaksali trebali bi poneti izvestaj kojim dokazujete da imate hepatitis c .Zemlhe u kojima je to moguce su Indija,Egipat,Alzir i Banglades.U ovim zemljama moze se od lokalnih doktora dobiti recept i za tu uslugu bi platili ne vise od 20 dolara.Cena tretmana bila bi od 500 do 750 dolara u zavisnosti pd toga koji su lekovi prepisani.Ovo takodje ima troskove puta i smestaja ali ako bi nasli jeftiniji let mogla bi biti dobra opcija.U ovom slucaju mogu vam dostaviti dostupne kontakte dostavljaca u Indiji.

Opcija  4.

Lekove za hepatitis c poslati u Srbiju preko zemalja.koje dozvoljavaju uvoz lekova za licnu upotrebu .U ovom slucaju mozete naruciti lekove iz Indije  i poslati u neku evropsku zemlju odakle bi se njihovom postom prepakovani u drugi paket posalali u  Srbiju na vasu adresu. Ova opcija dobro funkcionise i stedi troskove puta.Znaci da ako imate rodjake ili prijatelje u nekoj od navedenih zemalja lekovi.mogu biti poslati na njihovu adresu i oni vam.ih mogu proslediti kao sto sam objasnio. Ali mogu da asistiram ljudima iz Srbije kojima je potreban tretman  preko mreze volontera koji bi isto tako prosledili lekove u Srbiju na vasu adresu. Koja god vam opcija odgovara voljan sam da pomognem. Ako je problem pronalazak novca mogu da pomognem redukovanjem cene ,treba samo da mi se obratite i rado cu pomoci!Da bi narucili lekove preko mene evo sta potrazujem:

1 Neki izvestaj da imate hepatitis c

2.Adresu za dostavu i broj telefona

3. Uplatu

Lekovi i cene:

Izbor leka zavisi od genotipa kojim je lice inficirano .

Postojevtri glavna genotipa 1,2 i 3 i tri terapije bazirane ba Sofosbuviru koji tretra ove genotipe.Sofosbuvir 400 mg+Daclatasvir 60 mg moze se uzimati kao tretman za sva tri genotipa pritom je i jeftiniji tretman.Kostao bi 700 dolara za terapiju od 12 nedelja.Sofosbuvir 400mg +Ledipasvir 90 mg(Harvoni)efektivniji za genotip 1 i kostao bi 900 dolara za 12nedeljnu terapiju.Sofosbuvir 400mg +Velpatasvir100mg(Epclusa)koji je takodje za sve genotipe virusa,ali mnogo bolja za genotip 3.Za Sof +Dac terapijom za 12 nedelja procenat izlecenja je 85%znaci da je od 100 izleceno 85 ljudi  Svakako Epclusa je mnogo bolja za genotip 3 pa ce procenat izlecenja biti 92%.Iz ovog razloga dobro je znati kojim ste genotipom inficirani.Kako u Srbiji taj test kosta oko 200 dolara problem cene ponovo raste pa ako je novac problem ucinicu sve da pomognem.Greg Jefferys

The exact percentage of people in Serbia who are infected with Hepatitis C is not known but is likely to be at least 3% or 4%

Hepatitis C Treatment in Serbia

Over the past three years I have been helping people in Serbia to get Hepatitis C treatment because the situation in Serbia makes it almost impossible for Serbs infected with HCV to access the latest Hepatitis C treatments.

The situation for people in Serbia with Hepatitis C is probably the most difficult in Europe caused by the combination of poverty and government blocking access to generic treatments.

There is very little assistance available from within the Serbian health system for the average Serb with Hep C and even what is available is not ideal because Serbia is one of the very few countries is the world that still offers the dangerous and ineffective Peg Interferon + Ribavirin as a Hepatitis C treatment option.

Added to this lack of access to treatment within the Serbian health system the Serbian government actively and aggressively blocks Serbs from importing the more effective and affordable generic Hepatitis C treatments into Serbia.

So, this creates the double tragedy where Serbs cannot access treatment from Serbia’s health services because the Serbian government cannot afford to buy the new treatments, whilst not being allowed to import generic Hepatitis C treatments into Serbia at their own expense because the Government stops them.

This has resulted in a black market in Serbia that is controlled by criminal groups who charge desperate Serbs huge amounts for drugs that these criminals purchase very cheaply and then smuggle into Serbia. Prices of over US$2,000 are common for drugs that should be costing less than US$1,000.

Because the average wage in Serbia is very low ,000 represents almost one year’s wages. To save $2,000 is almost impossible for many Serbs so they are forced to borrow money to pay for their treatment. I personally know of people in Serbia who have had to sell their home to buy HCV treatment.

Before I go into the options for Serbs for accessing Hepatitis C treatment I will explain an international law concerning prescription medicines that does allow a window of opportunity.

This law, or treaty, allows people to cross borders with prescription medicines obtained in another country for personal use. The law allows a maximum of 12 weeks of medication to be carried. This concerns all prescription medicines except those containing prohibited drugs such as opiates or hallucinogenic chemicals.

This means Serbs with Hep C can travel to other countries to buy medicines.

I should also point out the reason that Serbs can not import such things as generic Harvoni or generic Epclusa directly from India. This is because Serbian Customs has a system where they “red flag” parcels from certain countries, including India. That is to say the Customs officials look more closely at parcels that come from countries like India or Egypt than they do for countries within the EU. This means that if you have a parcel sent directly from India to Serbia it will get closely inspected by Serbian Customs and when it is discovered that the parcel contains Hepatitis C Medicines the parcel will be seized and then returned to India or destroyed.

So, what are the options for Serbs with Hepatitis C?

Option 1.

If a Serbian person with Hepatitis C has a friend living in a country that allows importation of medicine for personal use then a simple option is to have the medicine sent to that friend and then travel to visit them and pick up the medicine and bring it home. For example, a number of countries in Europe do not require a prescription or other documentation to import medicine. These countries include Britain, Poland, Estonia, Russia and Greece. So, if you have a friend or relative living in one of these countries it is quite simple. It is perfectly legal for you to then return to Serbia with 12 weeks of Hepatitis C medication. I have organised such things often.

Option 2.

Travel to one of the above countries and get a temporary address in a hotel or Air B & B and have the medicines sent to that address. Usually, delivery times are very predictable so a stay of three or four nights will allow the medicines to arrive when you are there. Of course, this option does add costs of travel and accommodation.

Option 3.

Travel directly to a country that manufactures generic Hepatitis C medicines and purchase directly there and then return home with the medicines. In this case it is worth while to get a doctor in that country to write you a prescription. To make this easy you should take a medical report showing you have Hepatitis C.

The countries where this is possible are Egypt, Algeria, India and Bangladesh. In any of these countries there would be no problem getting a prescription and the local doctor would not charge more than $20 for this service. The cost of treatment would be between US$500 and $750 depending on the medicine required. Of course this also adds the cost of airfare and accommodation. But if you can get a cheap airfare to one of these places it is a very good option. In this case I can supply you with reliable contacts for suppliers in India.

Option 4.

Have the Hepatitis C medication sent to Serbia from a country that allows importation of medication for personal use.

In this option you can order the medication from India or one of the other countries and have it sent to someone in a European country who will then re-pack the Hep C medicines and forward on to your Serbian address.

This method works very well and saves the cost of travelling. So, for example, if you have a friend or family member living in Britain or Russia you would have your medicines sent to them and they would re-pack the medicines into a parcel or satchel and then send to you in Serbia.

In this case I can assist Serbs who need Hepatitis C treatment as I have a network of volunteers who will forward Hep C medicines to people in Serbia.

Which ever option will work best for you I am willing to help you. If finding the money to purchase your Hepatitis C treatment is a problem then I will also help you by reducing the price. You only have to ask and I will be happy to reduce the price.

To order Hepatitis C medicines through me these are the things I require:

1. Some form of medical report showing that you have Hepatitis C
2. A shipping address and contact phone number
3. Payment

Medication and Prices:

The choice of what type of Hepatitis C medicine is required is determined by the genotype of Hepatitis C a person is infected with.

There are three main genotypes of Hepatitis C. Genotype 1; Genotype 2 and Genotype 3.

There are three medicines based on Sofosbuvir that treat these genotypes.

Sofosbuvir 400 mg + Daclatasvir 60 mg can be used to treat all genotypes and is also the cheapest treatment. Sofosbuvir + Daclatasvir will cost US$700 for 12 weeks treatment.

Sofosbuvir 400 mg + Ledipasvir 90 mg (Harvoni) is effective against genotype 1 only and costs US0 for 12 weeks treatment.

Sofosbuvir 400 mg + Velpatasvir 100 mg (Epclusa) is effective against all genotypes of Hepatitis C.

A note of genotype 3.

Genotype 3 is currently the most difficult genotype of Hepatitis C to cure. In Serbia about 25% of people are infected with Hepatitis C genotype 3. Treating genotype 3 with Sofosbuvir + Daclatasvir for 12 weeks will give a cure rate of about 85%. That is to say 85 people out of every 100 people with G3 treated with Sof + Dac will be cured.

However Epclusa is much better than Sof + Dac for treating G3 and the cure rate will be better than 92% for people with G3.

For this reason it is very helpful to know which genotype of Hepatitis C you are infected with. However, in Serbia a genotype test will cost more about US0. So the problem of cost rises again.

If money is a problem then you should talk to me about it and I will do whatever I can to help you.