A recent study reveals that highly effective medications for hepatitis C infections have largely remained unused in the United States for the past decade.
Direct-acting antiviral drugs, hailed as a significant accomplishment in modern medicine, work by inhibiting key viral proteins responsible for replication. These oral medications are convenient to take, with minimal side effects, and provide a remarkable cure rate of 95% for patients.
Initially, there was optimism among doctors when the first of these therapies received approval in 2013, as it held the promise of relegating hepatitis C, a leading cause of liver transplants in the US, to the annals of medical history. Egypt, a country with high hepatitis C rates, has already achieved eradication of the disease, which can lead to liver cancer, failure, and death.
However, these therapies, initially priced around $90,000 for a course of treatment and once among the most expensive drugs in the country, have become emblematic of the severe disparities in the US healthcare system. Despite being a global leader in drug development, American patients, who pay more than double the prices compared to patients in other wealthy nations, often face challenges in affording these medications.
According to Dr. Jonathan Mermin, the director of the National Center for HIV, Viral Hepatitis, STD, and TB Prevention at the US Centers for Disease Control and Prevention, nearly 15,000 Americans lose their lives annually to hepatitis C, a preventable disease that has had a cure for over a decade. Dr. Mermin expressed his concerns during a news briefing.
The majority of new hepatitis C infections occur in individuals aged 40 and under
The current low cure rates coincide with a notable shift in the demographics of newly diagnosed hepatitis C infections.
Hepatitis C is transmitted through contact with infected blood or body fluids.
Historically, contaminated blood transfusions were a common source of infection before the implementation of virus screening in blood products.
According to Dr. Carolyn Wester, lead author of the study and director of the CDC’s Division of Viral Hepatitis, the age group most affected by hepatitis C has shifted from baby boomers to adults aged 40 and under, primarily due to increased injection drug use.
Riley Kirkpatrick, now 43 and executive director of Access Point of Georgia, attributes his infection to injected opioid use during his teenage years. He discovered he was infected in the early 2000s when interferon was the only available treatment, which had limited efficacy and significant side effects.
Hepatitis C can also be transmitted through various means, including sexual contact, contaminated tattoo needles, and from mother to child during pregnancy.
Aware of the imminent availability of more effective drugs, Kirkpatrick opted to wait for better treatment options based on his doctor’s advice.
Prompt medical attention is crucial
Swift treatment is crucial not only to prevent liver damage but also to halt further transmission of the infection, according to Wester.
Certain states, like Washington and Louisiana, have successfully expanded coverage by negotiating with drug companies to establish subscription services for the drugs, often referred to as the “Netflix model.”
These states calculated the projected cost of treating hepatitis C patients and offered a lump sum to the companies in exchange for comprehensive coverage for all individuals in need of treatment, as explained by Wester.
Collins emphasized the success of this approach and the government’s intention to implement it nationwide. While the initial cost is estimated at $5 to $6 billion, it is projected to save approximately $13.3 billion in treatment expenses over a decade.
A significant part of Collins’ role will involve persuading Congress to make this investment.
Wester expressed confidence in the viability of this approach, stating, “We have learned valuable lessons on how to implement this successfully. The challenge lies in finding the necessary political determination to achieve it.”
By Brenda Goodman, CNN
Published 1:08 PM EDT, Thu June 29, 2023
