HCV
The Debate Over Early Treatment
Why The Focus On HCV In Prisons and Jails?
An argument can be made with a shopping metaphor. When looking for the best deal, everyone goes to the place where you can get the most bang for your buck. Because of the prevalence of HCV in the correctional setting, it is an ideal opportunity to attack the hepatitis C virus..
Prevalence of HCV in Inmates and Detainees
The prevalence of HCV in the United States is estimated to be around 1% (1). However, the prevalence of HCV in correctional institutions is much higher. A recent estimate of HCV infection in US prisons is 17.4% (2), with chronic infection estimated to be between 12 and 35% (3). Correctional populations account for about one-third of all HCV cases in the US(4). The high prevalence of HCV in correctional settings is because many people most affected by incarceration, such as the poor, IV drug users, and the mentally ill, are more likely to have HCV.
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[1] National Center for Health Statistics, Centers for Disease Control. National Health and Nutrition Examination Survey. Available at: http://www.cdc.gov/nchs/about/major/nhanes/currentnhanes.htm. Retrieved 4.2.2014.
[2] Varan et al.Hepatitis C Seroprevalence Among Prison Inmates Since 2001: Still High but Declining. Public Health Reports, 2014; 129: 187-195.
[3] http://www.cdc.gov/hepatitis/Settings/Corrections.htm
[4] Varan et al.Hepatitis C Seroprevalence Among Prison Inmates Since 2001: Still High but Declining. Public Health Reports, 2014; 129: 187-195.
Arguments for & against Treating Hepatitis C Early In the Course of the Disease
Why spend taxpayer money on expensive drugs for Hepatitis C patients?
Why strategically pursue their treatment?
These are legitimate questions that deserve an earnest answer.
The proposed answer to the financial stewardship part of the debate is that it will save taxpayers money in the long run.
Arguments For...
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Expensive Drugs That Cure Hepatitis C Are Worth The Cost, Even At Early Stages Of Liver Fibrosis
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Hepatitis C in Oklahoma prisons is an expensive time bomb
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Arguments Against...
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6th Circuit: OK to ration hepatitis C treatment to prisoners
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Costly Hepatitis C Drugs Threaten To Bust Prison Budgets
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Expanding access to hepatitis C drugs will cost taxpayers and might not improve health
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VA, DoD spend more than $450M on costly hepatitis drug
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Rock and water are opposing forces, with one eroding and the other resisting erosion. This is an example of the dynamic relationship between two opposing forces. Neither force can claim 100% righteousness. Sometimes they have to find a way to coexist.
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Executive Summary
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Viral hepatitis is a serious, preventable public health threat that puts people who are infected at increased risk for liver disease, cancer, and death. The Viral Hepatitis National Strategic Plan for the United States: A Roadmap to Elimination (2021–2025) (Hepatitis Plan or Plan) provides a framework to eliminate viral hepatitis as a public health threat in the United States. Elimination is defined by the World Health Organization (WHO) as a 90% reduction in new chronic infections and a 65% reduction in mortality, compared to a 2015 baseline. The Hepatitis Plan focuses on hepatitis A, hepatitis B, and hepatitis C—the three most common hepatitis viruses and that have the most impact on the health of the nation. The Hepatitis Plan, which builds on three previous plans, is necessary as the nation faces unprecedented hepatitis A outbreaks, progress on preventing hepatitis B has stalled, and hepatitis C rates nearly tripled from 2011 to 2018. In 2016, it was estimated that 3.3 million Americans were living with chronic viral hepatitis: 862,000 with hepatitis B and 2.4 million with hepatitis C. Yet hepatitis A and hepatitis B are preventable by vaccines, and hepatitis C is curable in one short course of treatment. Reversing the rates of viral hepatitis, preventing new infections, and improving care and treatment require a strategic and coordinated approach by federal partners in collaboration with state and local health departments, tribal communities, community-based organizations, and other nonfederal partners and stakeholders.
The Hepatitis Plan provides goal-oriented objectives and strategies that can be implemented by a broad mix of stakeholders at all levels and across many sectors, both public and private. It serves as a mechanism to identify and leverage areas of synergy and resources and to avoid duplication of efforts across agencies. The Hepatitis Plan was developed under the direction of the Office of Infectious Disease and HIV/AIDS Policy (OIDP) in the Office of the Assistant Secretary for Health (OASH), U.S. Department of Health and Human Services (HHS), in collaboration with subject matter experts from across the federal government and with input from a wide range of stakeholders including the public.
Click on the link to the PDF to see what The Plan establishes as the vision for the nation.
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