New Hepatitis C Drugs Are Very Costly And Unavailable To Many State Prisoners

Health Aff (Millwood). 2016 Oct 1;35(10):1893-1901. doi: 10.1377/hlthaff.2016.0296.

Abstract

Prisoners bear much of the burden of the hepatitis C epidemic in the United States. Yet little is known about the scope and cost of treating hepatitis C in state prisons-particularly since the release of direct-acting antiviral medications. In the forty-one states whose departments of corrections reported data, 106,266 inmates (10 percent of their prisoners) were known to have hepatitis C on or about January 1, 2015. Only 949 (0.89 percent) of those inmates were being treated. Prices for a twelve-week course of direct-acting antivirals such as sofosbuvir and the combination drug ledipasvir/sofosbuvir varied widely as of September 30, 2015 ($43,418-$84,000 and $44,421-$94,500, respectively). Numerous corrections departments received smaller discounts than other government agencies did. To reduce the hepatitis C epidemic, state governments should increase funding for treating infected inmates. State departments of corrections should consider collaborating with other government agencies to negotiate discounts with pharmaceutical companies and with qualified health care facilities to provide medications through the federal 340B Drug Discount Program. Helping inmates transition to providers in the community upon release can enhance the gains achieved by treating hepatitis C in prison.

Keywords: Access To Care; Cost of Health Care; Disparities; Public Health; Special Populations.

MeSH terms

  • Adult
  • Antiviral Agents / economics*
  • Antiviral Agents / therapeutic use
  • Benzimidazoles / economics*
  • Benzimidazoles / therapeutic use
  • Female
  • Fluorenes / economics*
  • Fluorenes / therapeutic use
  • Hepatitis C / drug therapy
  • Hepatitis C / economics
  • Hepatitis C / epidemiology*
  • Humans
  • Male
  • North Carolina
  • Prisoners*
  • Prisons / economics
  • Prisons / organization & administration
  • Prisons / statistics & numerical data*
  • Retrospective Studies
  • Sofosbuvir
  • State Government*
  • United States
  • Uridine Monophosphate / analogs & derivatives*
  • Uridine Monophosphate / economics
  • Uridine Monophosphate / therapeutic use

Substances

  • Antiviral Agents
  • Benzimidazoles
  • Fluorenes
  • ledipasvir, sofosbuvir drug combination
  • Uridine Monophosphate
  • Sofosbuvir