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Nearly one in five Americans with hepatitis C spends time behind bars each year, making the prison system an opportune environment to test and cure potential transmitters of the disease.  The move could benefit public health but, as a new policy brief from the Institute for Patient Access explains, several barriers stand in the way.

Authored by Frederick Altice, MD, “Testing and Treating Prisoners for Hepatitis C” doesn’t shy from an honest assessment of those barriers, which include:

Dr. Altice counters these reservations with several points:

The paper also suggests negotiating with pharmaceutical companies to find a manageable price for treating the population.

The paper notes that jails often house inmates for a short period of time. So while they do not provide an ideal environment for treating hepatitis C, which takes eight-12 weeks, they present an opportunity for testing. Prisons are a more likely environment for treatment.

Under a U.S. Supreme Court ruling, Estelle v. Gamble, prisons are legally responsible for treating prisoners’ health conditions. But the protection sometimes works against patients with hepatitis C; prisons may hold back on testing detainees so they don’t make themselves legally liable to treat those whose tests yield a positive result. Several prisoners have had to take legal action to receive treatment, the paper notes.

Calling the availability of hepatitis C cures a “watershed moment for patients and health care providers,” Dr. Altice explains that policymakers must work toward solutions that make cures accessible for prisoners with hepatitis C and protect the larger public health interest.

For more, read “Testing and Treating Prisoners for Hepatitis C.”

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