Lance Gibson carried a time bomb for decades.

It was there with the Canadian Forces sergeant on a four-year stint serving in Germany. It was there on a tour of duty in Afghanistan.

But it wasn’t until a routine exit medical in 2009, as he prepared to leave the military and go to work in private security, that blood tests raised some red flags.

A few more tests and down came the diagnosis: Hepatitis C.

A back trace eventually found the source: a transfusion of tainted blood platelets in 1981.

He had had no idea.

“It had never really presented itself,” said Gibson, 50. “I deteriorated quite quickly after that. I went from, in 2009, feeling fairly healthy, contrary to what my blood work might have said, to in 2012 really needing a liver transplant or I would have died.”

Gibson couldn’t be released sick, so he had to give up his future plans and stay on in the military. His sister donated part of her liver and on May 16, 2012, the transplant was successful. But the disease would, in time, begin attacking that new liver, too.

Gibson learned of two new drugs, sofosbuvir and simeprevir, approved by Health Canada in late 2013, that are curing hepatitis C at rates as high as 90 per cent. It’s the first ever chance to actually — eventually — eradicate the virus.

But simeprevir and sofosbuvir are expensive. Simeprevir, sold under the name Galexos in Canada by Janssen Inc., costs roughly $36,000 for a 12-week course of treatment. Sofosbuvir, marketed by Gilead Sciences Inc. as Sovaldi, costs $55,000.

The Ontario drug plan doesn’t cover them, nor do many private plans.

Gibson was lucky. The military agreed to pay for the treatment right away. On March 10, 2014, Gibson took his first two pills, one of each drug. (Each can be used with older drugs, but it’s thought that using them together brings the best results.) If one more test of his now-nonexistent viral load comes back negative, he will be considered cured.

“If it wasn’t for the military, I wouldn’t have got those drugs,” said Gibson. “(The disease) is curable. . . . The treatment should be available to everybody.”

So far, Quebec is the only province that pays for them, though not in all circumstances.

Hepatitis C is caused by a virus that attacks the liver. Some people are able to fight off the virus, but many develop chronic hepatitis C, which slowly leads to cirrhosis, cancer and/or liver failure. It spreads through blood-to-blood contact: tainted blood transfusions, dirty needles, shared razor blades, and more.

An estimated 250,000 people in Canada have hepatitis C, though about one in five don’t know it. It kills more Canadians each year than any other virus. A transplant can buy patients time, but as long as the virus is in their body, it will continue to attack the new liver.

For more than a decade, the treatment of choice has been antiviral therapy with the drugs interferon and ribavirin. The combination cured only about half of the patients who received it, and many people can’t tolerate the treatment, which carries a slew of nasty side effects.

Simeprevir and sofosbuvir offer another more effective choice with fewer side effects.

The Canadian Agency for Drugs and Technologies in Health, which makes recommendations to provinces on what drugs and procedures to fund, is currently reviewing sofosbuvir. In June, it recommended funding simeprevir in combination with interferons and ribavirin, to treat some types of the virus.

Ontario’s Committee to Evaluate Drugs has reviewed simeprevir but has yet to issue its final recommendation on whether or not the province should fund it. It will look at sofosbuvir once the CADTH has issued its recommendations.

The final decision on whether to publicly fund drugs lies with the executive officer of Ontario Public Drug Programs.

At least one other province, British Columbia, is also reviewing simeprevir.

There is no timeline for when those decisions will be made. For Steve Larmand, Ontario’s could well come too late.

The 54-year-old from Newmarket says he’s nearing end-stage liver disease, and other treatments didn’t work or were intolerable. On disability payments after a motorcycle accident years ago, there’s no way he could afford the drugs.

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“If (the drugs) are going to be covered, it’ll be after I’m dead,” said Larmand.

Others are looking abroad. While the drugs are expensive in Canada and even more so in the United States, Gilead recently struck a deal with the Egyptian government to provide sofosbuvir for $900 for the full course of treatment.

Christian, whose mother contracted hepatitis C through a blood transfusion after giving birth to him 30 years ago in Romania, said the family is researching treatment overseas.

He doesn’t want his mother’s name or their family name published for fear of the stigma that still surrounds the disease.

The family is financially stable, said Christian, but the drug that could save his mom is still out of reach.

“The prices are absolutely ridiculous, above what we can afford,” he said. “It’s one of those things only the rich can afford, while everyone else is dying around them.”

Kate Hanna, a spokesperson for Janssen, said simeprevir is priced comparably to similar drugs.

“The price of simeprevir reflects its value to patients and the healthcare system,” wrote Hanna in an email to the Star.

Similarly, Michele Rest, of Gilead, said sofosbuvir is comparably priced to the currently approved treatments for hepatitis C in Canada.

Internationally, pricing is tiered based on a country’s ability to pay, Rest wrote in an email.

“Gilead also considers an individual country’s (hepatitis C) burden, treatment needs and economic means when setting prices, and we are committed to advancing access to Sovaldi worldwide as quickly as possible.”

Dr. Morris Sherman, an expert on viral hepatitis and liver cancer at Toronto General Hospital, said Canada needs to develop a strategy to ensure access to the drugs. Hepatitis C is expected to cost the Canadian health system enormously in the next couple of decades, as those already infected reach the stage of liver cancer, cirrhosis or need a transplant. But providing the drugs to everyone with hepatitis C in a short period of time would simply be too expensive for provincial health purses to manage.

“We’re facing an unprecedented health-care situation in Canada, where we have a very large number of people who have hepatitis C and who are at risk for all of these bad outcomes, and we have curative treatment, which is hugely expensive,” said Sherman.

“The big challenge is going to be, how do we manage hepatitis C treatment so that those patients who need (the drugs) get it soonest, and so that those whose need is less still have the opportunity to be treated at some point in their lives?’

“It’s just not right that somebody who needs treatments or wants treatment for an infectious disease, who may be stigmatized by having this disease, does not have access to treatment.”