Hep B Blog

Monthly Archives: July 2016

Hepatitis B Advocacy, Living with Hepatitis B

World Hepatitis Day: Because 4,000 Deaths a Day Is 4,000 Too Many


save-7-million-lives-2-212x300By Christine Kukka

The World Health Organization has designated July 28 as World Hepatitis Day, a day to work for global change to eliminate viral hepatitis and the suffering, death and discrimination that accompanies hepatitis B and C by 2030.

From Asia to North America, on this day people around the world raise awareness about viral hepatitis and advocate for better access to treatment and prevention programs and more effective government action. Why? Because 4,000 deaths a day from viral hepatitis is 4,000 deaths too many.

This action is critical, because for too long global leaders have made hepatitis a low priority. Viral hepatitis is a silent disease that causes no symptoms until it’s too late, and many believed the hepatitis B vaccine would simply make the infection go away.

Instead, global health organizations focused on other diseases such as HIV/AIDS, tuberculosis and malaria. HIV especially benefited from unprecedented efforts and donated resources to enable diagnosis and prevention of transmission and to provide treatment at low cost.

Today, we need the same effort and resources to eradicate viral hepatitis, which kill an estimated 1.4 million each year – more people  die from hepatitis annually than from HIV/AIDS and tuberculosis combined.
no-hep-for-all-2-212x300For example, between 5 to 20 percent of the 1 billion people living in Sub-Saharan Africa have chronic hepatitis B Despite this prevalence, there are no widespread screening, education or prevention programs in Africa. The majority of people lucky enough to get screened and diagnosed for hepatitis B are often blood donors, because there are no public health clinics that provide screening for viral hepatitis.

In Asia and Africa, even when pregnant women are diagnosed with hepatitis B, their newborns are often not given that critical, first vaccine dose within 12 hours of birth that would break the mother-to-child hepatitis B infection cycle. The birth dose of the hepatitis B vaccine is either too costly or simply unavailable. Perinatal infection, though preventable, continues to be a major source of chronic infection worldwide. Continue reading "World Hepatitis Day: Because 4,000 Deaths a Day Is 4,000 Too Many" →

Hepatitis B Advocacy, Living with Hepatitis B

Join the Conversation at the Hep B United Summit; Watch the Summit On Periscope!

hepbunited-btnThe annual Hep B United Summit, organized by the Hepatitis B Foundation, convenes in Washington D.C. from Wednesday, July 27 through Friday, July 29. National and local coalition partners, experts, stakeholders, and federal partners will meet to discuss how to increase hepatitis B testing and vaccination and improve access to care and treatment for individuals living with hepatitis B.

You can watch many of these important sessions LIVE on Periscope. You can also follow the conversation at the Summit on Twitter with #Hepbunite!

What is Periscope? Periscope broadcasts live video worldwide, in real time, so you can watch it from your computer (via web link) or a mobile device (via Periscope app). The app is free and available for your phone (iPhone and Android) and iPad or Tablet.

Wondering how to use Periscope to watch the Hep B United Summit in real time? There are two options:

  • If you’re using a PC, keep an eye out for a tweet from Hep B United and/or the Hepatitis B Foundation Twitter handles (@hepbunited or @hepbfoundation) that will contain a link to take you directly to the stream.
  • If you’re on the go, you can download the Periscope app for free from the App store or Google Play. You can either login using Twitter or directly with your phone number. Create your Periscope username and then follow hepbunited and hepbfoundation. We’ll be sure to follow you back! Here’s a great Periscope tutorial from Traffic Generation Café to get you started. You can also click on the link from your twitter app.

Here are the details on the sessions that will be broadcast on Periscope:

State of Hepatitis B
1:45-2:15 p.m. Wednesday: Brian McMahon, MD, will provide an update on the state of hepatitis B globally, via a GoToMeeting connection.

Click and watch later here. 

Hep B United and Know Hepatitis B Campaign Accomplishments
2:15-3 p.m. Wednesday:  Cynthia Jorgensen, DrPH, of the CDC’s Division of Viral Hepatitis will provide an update on Hep B United and the Know Hepatitis B campaign accomplishments of the past year.

Click and watch here.

HHS Town Hall on Hepatitis B
9:30 a.m. Thursday:  There will be a town hall conference with U.S. Department of Health and Human Services (HHS), live from HHS.

Click and watch here.

Breakout Session 1:

Developing New Hepatitis B Partnerships and Increasing Awareness
10:45-12:00 p.m. Friday: Contribute and learn about expanding outreach to new sectors (businesses, other at-risk communities, providers, etc.) and hepatitis B education strategies including social and ethnic media engagement. (Facilitators: Thaddeus Pham and Arcadi Kolchak)

Click and watch here.

Leveraging Data and Evaluating Impact
10:45-12:00 p.m. Friday: Discuss and collaborate on hepatitis B data collection and publication strategies, working with IRBs, and leveraging data to evaluate and promote coalition/organization impact. (Facilitators: Moon Chen and Chari Cohen)

Click and watch here.

Breakout Session 2:

Building and Sustaining Local Hepatitis B Coalitions
1:15-2:30 p.m. Friday: Develop strategies to sustain local hepatitis B coalitions and learn about engaging staff and local leadership. (Faciliators: Alex Shirreffs and Mohammad Abdul-Kadir)

Click and watch here.

Navigating Patients and Linkage to Care Strategies
1:15-2:30 p.m. Friday: Contribute to and learn about patient navigation strategies, including overcoming language barriers and working with community health workers and physician champions. (Facilitators: Nirah Johnson and Jane Pan)

Click and watch here.

 Not able to join the sessions with Periscope? Follow the conversation on Twitter using the #Hepbunite hashtag. Follow the events, RT and engage with event attendees and help us raise hepatitis B awareness in the U.S. and around the globe.

World Hepatitis Day is July 28th, and this Summit is a terrific opportunity to share with the world what we’re doing to help those living with hepatitis B in our communities.

Other popular hashtags for World Hepatitis Day, and to raise HBV awareness, include: #NOhep, #KnowHepB, #WorldHepDay, #WHD2016, #hepatitis, #hepatitisB, #HBV, and #hepB

Connect with, follow and engage with some of fellow partners on twitter to keep the HBV conversation going during the HBU Summit and World Hepatitis Day events, and beyond. Check out: @AAPCHOtweets, @AAHC_HOPEclinic, @AAHI_Info, @AAPInews, @apcaaz, @APIAHF, @ASIAOHIO, @CBWCHC, @CCACCInc, @cdchep, @cpacs, @HBIDC, @HepBFoundation, @HepBpolicy, @HepBProject, @HepBUnitedPhila, @HepFreeHawaii, @HHS_ViralHep, @ImmunizeAction, @LaoCenterMN, @MinorityHealth, @njhepb, @nemssf, @NVHR1, @nycHepB, @NYU_CSAAH, @sfhepbfree, @supportichs, @WhiteHouseAAPI,

Missing from the list? Contact the foundation at info@hepb.org to be added.

Don’t forget to join the World Hepatitis Alliance Thunderclap and register your World Hepatitis Day events.

nohep logo

Still have questions? Email us at info@hepb.org and we’ll help you get started!

Visit the Hep B United and Hepatitis B Foundation websites for more information about hepatitis B and related programs.

Hepatitis B Treatment, Living with Hepatitis B

Closing a Healthcare Gap: Medicare Finally Covers Hepatitis B Testing in At-risk Seniors

Image courtesy of stockimages at FreeDigitalPhotos.net
Image courtesy of stockimages at FreeDigitalPhotos.net

By Christine Kukka

Medicare insurance pays for seniors to get vaccinated against hepatitis B, but it doesn’t cover testing to find out if they’re infected and need life-saving treatment. The federal government is now poised to close this glaring healthcare gap that prevents at-risk seniors from getting screened for hepatitis B.

Last week, the Centers for Medicaid and Medicare Services proposed to cover hepatitis B testing in seniors age 65 and older who may be at risk of the liver infection.

Currently, the majority of the estimated 2 million Americans with chronic hepatitis B are over age 50, and the longer they are infected, the higher their risk of liver damage and cancer. This preventive screening saves lives and is cost-effective, because treatment with antivirals quickly and effectively reduce liver damage.

Until the Hepatitis B Foundation, Hep B United, the Association of Asian Pacific Community Health Organizations and the National Viral Hepatitis Roundtable asked the federal government to cover screening,  seniors who wanted to be tested for hepatitis B had to pay for the test themselves. Because hepatitis B is a “silent” infection, causing few symptoms until cirrhosis or cancer develop, nearly two-thirds of Americans living with hepatitis B have never been tested, identified or referred to life-saving treatment.

The highest rate of liver cancer in this country is in Vietnamese-American men, many of whom were never tested for hepatitis B. By the time they are diagnosed, it is often too late. Here’s two more examples of the high cost of this healthcare gap:

  • The Charles B. Wang Community Health Center in New York City serves a large Asian-American population. When the clinic screened all of its patients for hepatitis B, it found 7.8 percent of patients age 65 and older were chronically infected and 45 percent had been infected in the past.
  • Another New York City study of African immigrants, which included all ages, found 9.6 percent of them were chronically infected.

Today, the most vulnerable Americans are infected at a rate 10-times the national average, yet until now the government didn’t cover the cost of screening them. Medicare did cover testing if there were signs of liver damage from other medical tests, but in the case of late-stage hepatitis B infections, a diagnosis often comes too late for treatment.

Screening seniors for hepatitis B has a life-saving ripple effect across generations. When hepatitis B is diagnosed in a grandparent, there is an opportunity to educate, test and vaccinate their children and grandchildren who are also at risk.

Under the new guidelines, which also apply to disabled people covered by Medicare Part B, Medicare will reimburse primary care providers when they screen people at risk of hepatitis B, including:

  • People born in regions with high hepatitis B rates, including Asia, Africa, the Middle East, the Caribbean, Eastern Europe, and some areas of South and Central America.
  • Second-generation residents who were not vaccinated at birth and whose parents come from high-risk regions, such as sub-Saharan Africa and central and Southeast Asia
  • HIV-positive persons, injecting drug users, men who have sex with men, and
  • Family and household members of people with chronic hepatitis B.

This expanded coverage will go far to screen seniors, but gaps remain.

Under the proposed guidelines, only primary care providers can order testing, but many specialists including oncologists, rheumatologists and gastroenterologists see patients at risk for hepatitis B. The expanded coverage should include them and also pharmacists.

Additionally, both providers and the public need to know more about hepatitis B. Today, the majority of people infected with hepatitis B don’t know they’re infected. Patients often don’t share their true stories of activities that may put them at risk of hepatitis B, especially if it includes sexual abuse or injecting drug use, and doctors often don’t have the time or the skills to elicit this vital information. Along with expanded coverage should come public education to provide a common language for these difficult conversations.

Lastly, while providers are screening more Asian-Americans for hepatitis B, many of those at-risk remain undiagnosed, including first- and second-generation African immigrants.

This expanded Medicare coverage is long over-due, but we have a long way to go.

To read the proposed, expanded coverage for hepatitis B testing,  please click here.

To submit a comment about the proposed coverage, click here .

 

Living with Hepatitis B

Changing Jobs? How to Find the Best Employer Health Plan When You Have Hepatitis B

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getting-a-job-200x300
Image courtesy of stockimages at FreeDigitalPhotos.net

By Christine Kukka

You’ve just landed a new job with a better paycheck, but how do you make sure your new health plan covers the tests, doctor visits and medications needed for your or a family member’s hepatitis B?

Many people with chronic medical conditions find switching health plans can affect the quality of their medical care and requires a careful calculation of what their out-of-pocket healthcare costs may be in the year ahead.  There’s a lot to consider and doing your homework is essential to finding the best employer insurance plan for your health and your wallet. Two key questions to ask are:

Can I keep the same family doctor and/or liver specialist?  You don’t want to lose the expertise and personal rapport you may have developed with a provider. And, hepatitis B specialists are few and far between in many regions. Find out what doctors and specialists the new plan covers. Some plans offer several options, so find out which one covers your doctor. If the new plan doesn’t include your liver specialist, are you willing to pay extra to stay with him or her? For more information about health insurance terms and shopping for a plan, click here.

How do you make sure the new plan covers your drugs and lab tests? And how do you find this out without disclosing your hepatitis B? First, you cannot be denied coverage — or a job — because of your hepatitis B. The Affordable Care Act prohibits employers from denying anyone coverage because of a pre-existing health condition. However, you need to do your homework and look carefully at the deductibles, copays and coinsurance a plan offers.

When you are offered the job, or when you go for your benefits interview with the HR rep after accepting the job, ask for a copy of their health insurance plan and read it over carefully. It may be available online.  Ideally, you want coverage that covers the most and costs the least after you add up your monthly premiums (the amount you pay each month toward insurance coverage) and the copays (the portion you pay for drugs, lab tests, and doctor visits.)

If you or your family’s medical costs are high, you may find that selecting a plan with a high monthly premium may be the most affordable because your copays for tests and medications will be low.

To find out what costs you can expect (knowing you can’t predict every future medical event), try this exercise. Find out how much you paid during the past year for both premiums and out-of-pocket copays for drugs, lab tests, and doctor visits.

Now look at your new plan’s options. Assuming you have the same prescriptions, lab tests and doctor visits, how much would you pay under the new plan? If you have a choice of plans, apply the same test to each. Which plan is the least expensive when both copays and premiums are added up?

Look at a plan’s prescription pricing carefully. While health plans can’t openly refuse to insure people with costly, pre-existing conditions, some inflate the amount you pay for the two leading hepatitis B antiviral drugs (Viread and generic entecavir) to deliberately discourage people with chronic hepatitis B from choosing their health plans.

Every insurance plan has a drug formula overview in its description, which you have access to. It assigns a price “tier” to each drug. A low-cost generic antibiotic may be a Tier 1 and cost you only a $5 copay while a new, brand-name drug is assigned a pricier Tier 4 or 5 ranking and could be extremely expensive.

Look up any medications you are currently taking, or may take in the near future. For example, if your doctor has warned you that an antiviral may be in your future if your liver enzyme tests continue to rise, you will want to review your plan’s pricing for entecavir or tenofovir. If the health plan charges a high monthly copay for a generic antiviral such as entecavir, you may be able to file a complaint. Email the Hepatitis B Foundation at info@hepb.org for more information.

Reviewing health insurance coverage details isn’t easy, but it’s important to make sure your new health plan will be the best for you and your family.

What do you do if there is a one- or two-month lag before your new coverage begins? When you leave a job, you may be able to keep your old job’s health insurance coverage for several months. This is called COBRA continuation coverage. Under COBRA, you usually have to pay the entire monthly premium yourself, plus a small administrative fee. This may be costly, but if it provides good coverage and if you’re due for your annual physical, lab tests and ultrasound, or if you need to continue antivirals, it may be a good option.

Another option is the Health Insurance Marketplace . Also known as “Obamacare,” this helps uninsured people find and apply for quality, affordable health coverage, and low and middle-income people may qualify for lower costs based on their household size and income. Losing your health insurance because you’re changing jobs may qualify as a “life changing event” that allows you to apply. For more information on marketplace health plans and hepatitis B, please click here.

Another option is short-term or temporary health insurance coverage. For more information click here.

Baruch S. Blumberg Institute