New Lease on Life

August 21, 2014
BY Allie Freedman
There’s a cure for Hepatitis C, but it comes with a cost

Not many people who battle drug addiction and Hepatitis C live to tell about it. Yet, 62-year-old Baltimorean and former county drug czar Mike Gimbel fought and conquered both.

Mike Gimbel, a Hepatitis C survivor, battled back from heroin addiction (below, when he was admitted to rehab) to a 25-year career as director of Baltimore County’s Office of Substance Abuse. (Photos provided)

Mike Gimbel, a Hepatitis C survivor, battled back from heroin addiction (below, when he was admitted to rehab) to a 25-year career as director of Baltimore County’s Office of Substance Abuse. (Photos provided)

Gimbel, a former heroin addict, spent his teenage years leading a double life. By day, he was a typical Jewish boy from Pikesville. By night, he was scouring the streets of Baltimore for drugs. Nearly bankrupting his family, Gimbel spent about $250 a day to satisfy his drug habit.

“I had no idea what long-term damage I was doing to my body,” he said. “To be honest, I’m lucky I made it to 20.”

After several near-death overdoses, his parents convinced him to admit himself to Synanon, a drug rehabilitation center in Santa Monica, Calif. “I was so far gone that I overdosed on the airplane to the treatment center,” he said. “My dad is my Schindler. He, along with my mom, saved my life and gave me a second chance.”

Gimbel returned home sober seven years later and quickly made a name in the drug-prevention world. Transformed from Jewish junkie to drug czar, Gimbel became the first director of Baltimore County’s Office of Substance Abuse in 1980 and served for 25 years. Despite nearly 43 years of sobriety and a career in drug prevention, Gimbel feared that repercussions from his drug abuse would steal years away from his life. A doctor’s diagnosis confirmed those fears.

In 1998, Gimbel learned he had contracted Hepatitis C from sharing dirty needles during his years of drug use. Though he had no physical symptoms, his liver enzyme levels were rapidly increasing. He enlisted the help of gastroenterologist Anurag Maheshwari at Mercy Medical Center to carefully monitor his health until the right treatment came along.

“It was like playing Russian roulette,” said Gimbel. “I wanted to bet my chances and hold off for the best cure possible. In July, Dr. Maheshwari told me about a new drug being developed, Sovaldi. I asked him when it would be approved by the FDA. He told me Dec. 6, 2013. I made an appointment for Dec. 7.”

With an 80 to 90 percent cure rate, Sovaldi is a medical breakthrough for patients with Hepatitis C. Developed by an American biopharmaceutical company, Gilead, Sovaldi is an NS5B inhibitor, which means it prevents the Hepatitis C virus from replicating in the body’s RNA.

A single Hepatitis C virus can multiply up to a million copies in a day, but the drug can stop it from multiplying and ultimately cure the disease, said Maheshwari.

“For the first time, we have a treatment that cures Hepatitis C quickly and with fewer side effects,” said Maheshwari. “We always knew Hepatitis C is a curable disease, but Sovaldi is a potent inhibitor. In just 12 weeks of medication, patients are done with Hepatitis C for life.”

Sovaldi on its own will not cure Hepatitis C. For 12 weeks, Gimbel took one Sovaldi daily and two RibaPaks, an antiviral medication that reduces the amount of Hepatitis C virus in the body, and one weekly injection of PEGASYS, an interferon protein that augments the patient’s immune system. Within one month, his Hepatitis C was undetected in his blood work.

082214_hepatitis1“It is still surreal to me,” said Gimbel. “I still can’t believe it. They monitored my blood work for 12 more weeks once I went off Sovaldi. After all these years, I cannot believe [my Hepatitis C] is finally gone.”

However, Sovaldi comes at a steep cost.

Priced at $1,000 a pill, the total cost for Sovaldi is $84,000 for the prescribed 12-week period. Once patients add in costs for other medications and medical assistance, Hepatitis C treatment can easily top $150,000. Not all patients can afford treatment; Gimbel’s insurance covered his costs.

In 1991, Joel Bernstein was doing his job as a physician’s assistant at Sinai Hospital.

“With one simple needle cutting my thumb, I got stuck with Hepatitis C,” said Bernstein. Since then he needed and received a liver transplant, endured fevers of more than 105 degrees and suffered from general bad health. Bernstein has been unemployed since 1998 due to the disease.

Bernstein cannot afford insurance that would cover the costs: “It is hard knowing there is a magic pill to cure me but that I cannot get it,” he said. “I do not have the funds to cover $1,000 a pill.”

It is no surprise to Maheshwari that Sovaldi comes with such a large price tag. “They have a short window of time where they have a monopoly,” he said. “There are similar medications being developed to Sovaldi that will be approved later this year. As the competition heats up, the price will go down.”

Bernstein hopes to raise money to fund his treatment despite its high cost.

“My Hepatitis C is active and progressive,” said Bernstein. “It is a full-body disease and affects all aspects of my health. If I could cure my Hepatitis C, it would be a huge weight lifted off my shoulders. I would frame my blood results and bow down to them every night.”

More than three million Americans suffer from Hepatitis C. Passed through blood transmission, Hepatitis C can be spread by sharing needles and sexual contact, among other ways. Nicknamed the silent disease, Hepatitis C can lie undetected for decades without proper testing.

According to a United States Health and Human Services’ 2011 report, 65 to 75 percent of infected Americans remain unaware of their Hepatitis C status. Conversely, Hepatitis C has surpassed HIV/AIDS as a leading cause of death in the U.S. and is the leading cause of liver cancer and liver transplantation in the country.

“I was a ticking time bomb,” said Gimbel. “If I had not gotten tested, I never would have known I had it. I especially encourage the baby boomers, individuals born between 1945 and 1964, to get screened because that generation makes up more than 75 percent of Hepatitis C victims.”

Maheshwari also emphasized the importance of getting tested and raising awareness about Hepatitis C.

“We come across patients who either do not know that they have it or feel like they have to live with the disease forever,” he said. “Hepatitis C is a curable disease, and there is no reason to live with it for the rest of your life. With new medical breakthroughs like Sovaldi, you can get cured in 12 weeks.”

For Gimbel, access to Sovaldi has been like a new lease on life.

“I feel like I’ve cheated death twice, said Gimbel. “I was lucky enough to survive my heroin addiction, but I never thought I would be cured of Hepatitis C. I always figured I would need a liver transplant or die of liver disease. It is a medical miracle.”

Allie Freedman is a local freelance writer.

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