Story URL: http://news.medill.northwestern.edu/chicago/news.aspx?id=230723
Story Retrieval Date: 7/28/2014 11:25:45 AM CST

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Hepatitis C virus


Illinois prisons approve new hepatitis C drug for inmates, but not all to get it

by Jenn Stanley
May 21, 2014


Only a small fraction of the state’s prison inmates infected with hepatitis C could likely receive a new highly effective treatment approved for use by the Illinois Department of Corrections.

The Food and Drug Administration approved Gilead Sciences, Inc’s $1,000 per-pill “wonder drug,” Sovaldi, in December 2013. The decision by the IDOC sparked debate among state lawmakers, as one course of treatment costs about $84,000. 

Currently, anywhere between 2,500 and 3,700 Illinois prisoners have been diagnosed with  hepatitis C, leaving many to question how the treatments will be financed.

IDOC spokesman Tom Shaer noted that the state will be allowed a discounted price $65,000 per course of treatment, but he conceded that not every inmate with hepatitis C will receive it.

“We don’t willy-nilly, automatically use it for everyone. We have a strict evaluation process,” Shaer said, “but cost cannot legally be a factor.”

In fact, Shaer estimated that throughout the next year, the IDOC will only spend $3.5 million on Sovaldi, which is well within the 2014 health services budget of $140 million. That would mean that only about 54 inmates, just 2 percent of those infected with hepatitis C, would be prescribed this treatment.

Shaer said that the attending doctor’s best judgment and length of time left to serve in prison are factors in deciding who would get the drug, as other treatments for hepatitis C are available. Sovaldi, however, has been rated 95 percent effective, as opposed to other medications with success rates closer to 50 percent. Gilead Sciences also boasts shorter treatment time and fewer side effects with the drug.

A recent article in the New England Journal of Medicine pointed to the nation’s high incarceration rate as an “important public health opportunity,” as baby-boomers, who make up the majority of Americans infected with hepatitis C, age.

According to the Illinois Department of Public Health, about 70 percent of all hepatitis C carriers will develop chronic liver disease. Between 5 and 20 percent of those people will develop cirrhosis, and 1 in 5 people with cirrhosis will die from liver failure or liver cancer.

“We know this is going to come crashing down on us,” lead author Dr. Josiah D. Rich, professor of medicine and epidemiology at Brown University, said in a press release. “The next 10 to 20 years are going to be ugly…We can head off a lot of disease and expense if we invest now.”

 

(Revised with clarification, 10:45pm, 5/21/2014)