Hepatitis C (HCV) is a blood-borne virus that is typically spread through intravenous drug use (i.e., sharing needles), tattooing with non-sterile needles, and sharing razors, toothbrushes, nail clippers or other hygiene items that may be exposed to blood. It is often a chronic disease and, if left untreated, can lead to severe liver damage.
Recent good news in the battle against HCV, in the form of two new drugs that are highly effective in eliminating the virus, is tempered by the fact that the companies that produce the drugs have priced them at $60,000 to $80,000 per 12-week course of treatment. This high cost prices the medications beyond the reach of most prison and jail systems – which is especially troubling considering that a substantial number of prisoners are infected with HCV.
The new drugs, approved by the FDA in late 2013, are simeprevir, branded as Olysio and manufactured by Janssen Therapeutics (a Johnson & Johnson company), and sofosbuvir, branded as Sovaldi and manufactured by Gilead Sciences. Based on clinical trials, Sovaldi has an 84-96% cure rate while Olysio has an 80-85% cure rate. Both drugs are used in combination with other HCV anti-viral medications, peginterferon alfa and/or ribavirin, and their cure rates vary depending on HCV genotype – specific variations of the virus.
Unlike the current treatments for hepatitis C, Olysio and Sovaldi have fewer side effects, greater efficacy and reduce treatment durations by up to 75% (12 to 24 weeks rather than 48 weeks). In addition, the new drugs are administered orally rather than by injections. However, given tight corrections budgets and the high cost of the new HCV medications – Sovaldi costs approximately $1,000 per pill – getting them into prisons and jails ranges from difficult to impossible.
According to the Centers for Disease Control, “The prevalence of HCV infection in prison inmates is substantially higher than that of the general U.S. population. Among prison inmates, 16%-41% have ever been infected with HCV, and 12%-35% are chronically infected, compared to 1%-1.5% in the uninstitutionalized U.S. population.”
Josiah Rich, director of the Center for Prisoner Health and Human Rights at the Miriam Hospital Immunology Center in Rhode Island, noted that “With more than 10 million Americans cycling in and out of prisons and jails each year, including nearly one of every three HCV-infected people, the criminal justice system may be the best place to efficiently identify and cure the greatest number of HCV-infected people.”
Despite the need for improved drugs to treat prisoners with hepatitis C, the cost of the new medications is prohibitive for prisons and jails. Rich estimated that treating all prisoners currently infected with HCV would cost $33 billion. ..Continued.. by Greg Dober
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