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Ten years ago, safe and effective treatments for hepatitis C became available.
These pills are easy to take oral antivirals with few side effects. They cure 95% of the patients who take them. Treatments are also expensive, ranging from $20 to $25,000 per course.
A new report from the Centers for Disease Control and Prevention finds that the high cost of drugs, coupled with coverage restrictions imposed by insurers, have prevented many people diagnosed with hepatitis C from accessing curative treatments in the last decade.
The CDC estimates that 2.4 million people in the US are living with hepatitis C, a liver disease caused by a virus that is spread through contact with the blood of an infected person. Currently, the most common route of infection in the US is sharing needles and syringes used to inject drugs. It can also be transmitted through sex and childbirth. If left untreated, it can cause severe liver damage and liver cancer, and causes about 15,000 deaths in the US each year.
“We have the tools … to eliminate hepatitis C in our country,” says Dr. Carolyn Wester, director of the CDC’s Division of Viral Hepatitis, “it’s a matter of having the will as a society to make sure that these resources available to all populations with hepatitis C.
High cost and insurance restrictions limit access
According to the CDC’s analysis, only 34% of people known to have hepatitis C in the past decade have been cured or cleared of the virus. Nearly one million people in the US are living with undiagnosed hepatitis C. Among those diagnosed with hepatitis C over the past decade, more than half a million have not accessed treatment.
The high cost of the drug has led insurers to put “blocks in the way of people and their doctors,” says Wester. Some commercial insurance providers and state Medicaid programs will not allow patients to get the drug until they see a specialist, abstain from using drugs, or reach advanced-stage liver disease.
“These restrictions are not in line with medical guidance,” says Wester, “the national recommendation for hepatitis C treatment is that everyone with hepatitis C should be cured.”
To address the languishing uptake of hepatitis C treatment, the Biden Administration has proposed a National Hepatitis C Elimination Program, led by Dr. Francis Collins, former director of the National Institutes of Health.
“The program will prevent cases of liver cancer and liver failure. It will save thousands of lives. And it will be more than paid for by further reductions in health care costs,” Collins said, in a CDC teleconference with reporters Thursday.
The plan proposes a subscription model to increase access to hepatitis C drugs, in which the government would negotiate with drug manufacturers to agree to a one-time payment, “and then make the drugs available free to anyone.” Medicaid, uninsured, in the prison system, or on a Native American reservation,” Collins says, adding that this model for hepatitis C drugs has been successfully tested in Louisiana.
The five-year, $11.3 billion program is currently under consideration in Congress.