State prisoners have a higher-than-average rate of hepatitis C infection, but their chances of accessing a cure are uncommonly slim. A new study from Health Affairs reveals that less than 1 percent of prisoners with hepatitis C can get direct-acting antiviral treatments for the chronic disease. The study included 106,200 inmates across 41 state prison systems.
Treating prisoners presents a formidable challenge. While about one percent of the general U.S. population has hepatitis C, an estimated 17 percent of state prisoners are infected.
States vary in their willingness to provide prisoners with curative treatment – and in the price they pay for the innovative medicines. New York state has treated 600 inmates with hepatitis C cures, Business Insider reports. Meanwhile, Texas, which has the country’s largest prison population, has treated only 43 prisoners to date. STAT News reports that what individual programs pay per prisoner can vary from $43,400 to $94,500 for a 12-week regimen.
Even with steep prices, however, testing and treating inmates would be cost effective. A study published in the Annals of Internal Medicine reported that screening and treating patients could reduce hepatitis C costs by $260-$760 million. The approach could also prevent 5,500 to 12,700 new transmissions of the disease – both within prison walls and beyond.
Some prisons are rationing treatment based on patients’ level of risky behavior and their disease severity. Other prisons are partnering with eligible health care systems to buy the treatments through the government’s 340B drug discount program. The 340B program requires deep drug rice cuts for health care systems designed to treat indigent patients.
Still, many prisoners continue waiting – a risk in and of itself, as unchecked hepatitis C can lead to liver cirrhosis, liver cancer and continued disease transmission. Frustration has spurred inmates in Massachusetts, Minnesota, Pennsylvania and Tennessee to pursue legal action – a recourse that may become common as patients in other states grow sicker and more dissatisfied with their inability to access treatment.