Should I Immediately Self-Pay for Baraclude Treatment?

Q: Should I Immediately Self-Pay for Baraclude Treatment?

Hello： <br>1. <br>Currently, liver enzyme levels are elevated, and viral load is high, indicating liver inflammation. <br>It is advised to avoid excessive fatigue and to investigate the causes of liver inflammation. <br>Treatment for hepatitis B, including oral antiviral medicati

Is it necessary to immediately pay out of pocket for Belviq?

Dear Dr.
Lin,
I previously self-paid for Hepa-Merz and did not develop any drug resistance, but after stopping the medication for about a year, I experienced a relapse.
Currently, my GOT/GPT levels are (64/101 on August 18, 2011) and (120/240 on September 15, 2011).
My bilirubin levels are normal, and there is no liver cirrhosis.
I am positive for Hepatitis B surface antigen and negative for Hepatitis B core antigen, with HBV DNA at 260,000 copies/ml.
My current doctor mentioned that although my GPT is more than twice the normal level, I must wait three months before I can apply for insurance coverage, which means I can only apply after November this year.
I am considering whether to self-pay for Baraclude, and my doctor has advised me to make my own decision.
I would like to seek your opinion, Dr.
Lin.
Thank you!
Sincerely,
David
September 21, 2011

David, 40~49 year old female. Ask Date: 2011/09/21

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello:
1.
Currently, liver enzyme levels are elevated, and viral load is high, indicating liver inflammation.
It is advised to avoid excessive fatigue and to investigate the causes of liver inflammation.
Treatment for hepatitis B, including oral antiviral medications or long-acting interferon therapy, can reduce viral load and improve liver tissue.
Starting oral antiviral medication promptly has the benefit of controlling the condition earlier; however, these medications need to be taken long-term.
According to current treatment guidelines, if eAg is positive, it is recommended to stop medication only after HBV-DNA is undetectable for 3 to 4 tests or if S antigen turns negative.
Generally, treatment should last for at least 2 years or even longer.
2.
Currently, the National Health Insurance reimbursement policy states that for eAg negative patients, monitoring is required for a period of time, with follow-ups every 3 months.
If liver enzyme levels remain more than twice the normal value and viral load exceeds 2000 IU/ml, patients may be eligible for oral antiviral medication for 3 years or long-acting interferon treatment for 1 year, following physician evaluation.
Wishing you good health,
Dr.
Lin Ming-Hui, Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2011/09/21

More Info

When considering whether to immediately self-pay for Baraclude (entecavir) treatment for hepatitis B, there are several factors to take into account. Based on the information provided, you have a history of hepatitis B infection, with current lab results indicating elevated liver enzymes (GOT/GPT) and a significant level of HBV DNA. Your doctor has advised that you wait three months for potential insurance coverage, but you are contemplating whether to start treatment sooner by self-paying.

First, it is important to understand the implications of your current health status. Elevated liver enzymes suggest ongoing liver inflammation, which can be a sign of active hepatitis B infection. The presence of HBV DNA at a level of 260,000 copies/ml indicates that the virus is replicating in your body, which could lead to further liver damage if left untreated. The absence of hepatitis B core antibodies (anti-HBc) suggests that you are in the chronic phase of the infection.

Baraclude is an antiviral medication that is effective in suppressing HBV replication and can help reduce liver inflammation and prevent progression to more serious liver disease, including cirrhosis and liver cancer. Given your elevated liver enzymes and viral load, initiating treatment could be beneficial in managing your condition and preventing further liver damage.

The decision to self-pay for treatment should consider the following:
1. Severity of Your Condition: With elevated liver enzymes and high HBV DNA levels, there is a risk of liver damage. Starting treatment sooner rather than later may help mitigate this risk.

2. Potential for Disease Progression: Chronic hepatitis B can lead to serious complications over time. Early intervention with antiviral therapy can help control the virus and protect liver health.

3. Financial Considerations: Self-paying for medication can be costly, but it may be worth it for the potential health benefits. Consider your financial situation and whether you can afford the treatment without insurance coverage.

4. Consultation with Your Healthcare Provider: Since your doctor has left the decision to you, it may be helpful to have a more in-depth discussion about the risks and benefits of starting treatment now versus waiting for insurance coverage. Ask about the potential consequences of delaying treatment and whether there are alternative options available.

5. Monitoring and Follow-Up: If you decide to start treatment, ensure that you have a plan for regular monitoring of your liver function and HBV DNA levels. This will help assess the effectiveness of the treatment and make any necessary adjustments.

In conclusion, while the decision to self-pay for Baraclude treatment ultimately rests with you, the current state of your liver health suggests that starting treatment sooner could be advantageous. It is crucial to weigh the risks of delaying treatment against the potential benefits of immediate intervention. Discuss your concerns and options thoroughly with your healthcare provider to make an informed decision that aligns with your health goals.

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