For inmates in Colorado who have hepatitis C, the wait for treatment is almost over. The state settled a lawsuit last week that will significantly increase funding to cure prisoners, who could otherwise develop cirrhosis or liver cancer.
Direct-acting antiviral medications offer about a 90 percent cure rate. But cost concerns initially led states to use restrictive criteria to limit access to the treatment, spawning lawsuits across the country. Since the first hepatitis C cure became available in 2014, market forces have driven down the cost to a third of the original price.
And now, Colorado has established a spending commitment to put the therapies to use for the state’s inmates. According to Colorado’s settlement, the state will invest $20.5 million in direct-acting antiviral treatment in the current fiscal year, which runs until June 2019. Then another $20.5 million the following year.
This does not equate to “universal treatment,” the American Civil Liberties Union was quick to point out. The group filed the lawsuit on behalf of Colorado inmates. But the ACLU acknowledged that the funding should at least address the backlog of inmates who are waiting for treatment.
Though politically tenuous, curing prisoners benefits both the individuals themselves and the public health. Because inmates are a captive population, they may be more likely to complete the full treatment regimen – reducing their risk of liver failure and liver cancer. And as explained in IfPA’s “Testing and Treating Prisoners for Hepatitis C,” fewer infected inmates can reduce the risk of transmission within prisons and within the broader community once inmates are released.
“Curing hepatitis C before prisoners are released would be an effective public health strategy,” author Frederick Altice, MD, explains in the paper. There is also the potential for longer-term savings. “As much as $750 million over the next 30 years” could be saved by aggressively curing hepatitis C in prisons, the paper notes. This estimate is attributed to savings associated with treating liver damage, cirrhosis and cancer.
Outside of Colorado, the fight for access continues. In Massachusetts, the Department of Correction settled its lawsuit related to hepatitis C treatment for inmates earlier this year. Inmates there with advanced stage hepatitis C should begin direct-acting antivirals within the next year. And those with less advanced disease, within 18 months.
Lawsuits in five other states are ongoing.