Prisoners’ Hep C Treatment Is Effective But More Costly

Treatment for Hepatitis C in California prisons is now more effective but much more costly, according to a report.

About 17,000 prisoners in California have tested positive for Hepatitis C though health officials suggest the actual number is probably much higher, according to George Lavender for MarketPlace.

“… It’s a question of spending now versus later”

Liver cancer as a result of chronic Hepatitis C infection is the most common cause of cancer death in the state’s prisons. Intravenous drug use is a common way infection occurs, though sex and sharing needles for tattoos also play a part in spreading the disease, reports Lavender.

The disease affects about 1 percent of the country’s population as a whole, but 17 percent of those in prison, Lavender states.

The arrival of the new medications is “pretty miraculous,” said Dr. Johannes Haar, chief medical executive at the California Men’s Colony near San Luis Obispo.

Before the introduction of new drugs, the chances of actually being cured were about 50/50. That changed in 2011, when the FDA approved the first of a new generation of drugs.

California’s prison health care providers’ have been using two of those drugs, Sovaldi and Harvoni, since 2014. Haar said the new drugs raise the (success) rates close to 90 percent from “pretty much a toss of a coin.”

The new drugs are much more expensive. A course of treatment costs between $70,000 and $80,000, according to California’s prison health department. Last year the state saw medication costs skyrocket from just over $10 million to $47 million, states the report.

“While the drugs are expensive, liver transplants and treatment for patients with Hepatitis C in its later stages are also costly,” said Dr. Jagpreet Chhatwal, assistant professor of radiology at Harvard Medical School.

“Treating the disease in prison is worth it in the long run because cutting the number of infected people in prison has a dramatic impact on the number of people living with the disease society wide,” he said, adding “The average length of time anyone spends in prison is three years, but it can take 20 or even 30 years before the more damaging consequences of Hepatitis C manifest. The majority of those who had beenin prison have been released and would require treatment in the community.”

Chhatwal said, “If all prisons tested all prisoners and treated all those who needed it, they would diagnose between 41,900 and 122,700 new cases of the disease in prison over 30 years,” Lavender reported. It would require prisons on average to ramp up spending by an extra 12 percent. “It’s a question of spending now versus later.”

– David Eugene Archer Sr.

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