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Hepatitis C virus
BSIP | UIG | Getty Images
Federal health officials said Thursday that the vast majority of people in the United States who test positive for hepatitis C are not treated because of the high cost of oral antiviral treatments and obstacles posed by insurance plans.
Hepatitis C is often referred to as the silent killer because the initial infection has few or no symptoms. However, over time, the virus can cause liver damage, liver cancer, liver failure, and eventually death.
The virus spreads through contact with the blood of an infected person, primarily through sharing needles and other equipment used to inject drugs.
Oral antiviral treatment Gilead Sciences And Apve It has been on the US market for almost a decade now. Taken once a day for eight to 12 weeks, these pills cure more than 95% of hepatitis C cases.
Despite the availability of these drugs, a third of the million adults in the United States who tested positive for hepatitis C were treated between 2013 and 2022, according to a report from the Centers for Disease Control and Prevention published Thursday. Health officials estimate that as many as 1 million other people in the United States are infected but do not know they have the virus.
Hepatitis C contributed to nearly 15,000 deaths in 2020, according to the Centers for Disease Control and Prevention.
“Thousands of people die every year in our country, and many more have had a treatable infection for more than 10 years,” said Dr. Jonathan Mermin, director of the CDC division who specializes in HIV and viral hepatitis. Reporters on call Thursday.
The Biden administration has asked Congress to approve $11 billion in funding for a national program to eliminate hepatitis C by 2030. Dr. Francis Collins, who leads the initiative in the White House, said the program would save thousands of lives and pay for itself by reducing healthcare costs.
Health insurance and hepatitis care costs
Health officials said the primary barriers to treatment are requirements imposed by health insurance plans and the high cost of treatment. A course of pills can cost up to $24,000 per patient.
Some health insurance companies require onerous pre-authorization before patients can receive the pills and also which health care providers can prescribe the drugs, said Dr. Caroline Wister, who heads the division of viral hepatitis at the Centers for Disease Control and Prevention.
Collins, who previously served as director of the National Institutes of Health, said community health centers that treat the uninsured cannot afford pills for everyone. According to the Centers for Disease Control and Prevention, only one in four uninsured adults with hepatitis C has been treated.
Even the state’s Medicaid plans impose onerous requirements like evidence of liver disease, sobriety and involvement of specialists, Collins told reporters Thursday. The high cost of drugs has made it difficult for Medicaid to treat every infected person, according to the US Department of Health and Human Services.
Under Biden’s proposal, the federal government would pay drug companies like Gilead and AbbVie a lump sum for the drugs. The companies would then make the drugs freely available to the uninsured, state Medicaid programs, prison systems and people living on Native American reservations.
The proposal builds on a model Louisiana launched in 2019, in which the state paid Gilead subsidiary Asegua Therapeutics a lump sum for enough drugs over five years to treat nearly all of its Medicaid patients and people who are incarcerated.
Collins said the National Institutes of Health and the Food and Drug Administration are also working to approve a rapid hepatitis C test that will provide a diagnosis in an hour or less. The test will be used to diagnose and treat patients in a single visit, he said.
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