This page is an archive. Its content may no longer be accurate and was last updated on the original publication date. It is intended for reference and as a historical record only. For hep C questions, call Help4Hep BC at 1-888-411-7578.
Less than 1% of prisoners with hepatitis C in state correctional facilities in the United States are receiving treatment according to a new study in the October issue of Health Affairs conducted by the Association of State Correctional Administrators in collaboration with the Yale Global Health Justice Partnership. The study found that the main barriers to increasing access to care are the high price of the medications, the few policy options available for reducing drug costs for state correctional facilities and the lack of funding for state correctional health services to meet the needs of incarcerated patients.
Caught between costly hepatitis C medications and an enormous need for treatment, prison officials are forced to make difficult decisions about who to treat, explained A.T. Wall ’80, the Director of the Rhode Island Department of Corrections and a co-author of the study. “Patients and prison officials alike want to cure hepatitis C infections. That requires financial resources and discounts we don’t have. What we desperately need are less costly drugs and more funding.”
Hepatitis C, a liver disease that can lead to severe illness and death, affects 3 million adults in the United States, according to the Center for Disease Control and Prevention (CDC). About one-third of those people spend at least part of the year in correctional facilities. Two new hepatitis C medications, Sovaldi (sofosbuvir) and Harvoni (sofosvubir/ledipasvir), cure the vast majority of patients. However, they are extremely expensive, with list prices of $84,000 and $94,500 for a 12-week course of treatment of each drug respectively.
The study is the first peer-reviewed analysis in over a decade examining the scope of hepatitis C medical care in state prisons. The research examined testing, treatment, and drug spending. It was performed by a coalition of prison officials, doctors, and researchers using data provided by 49 of the 50 directors of state departments of corrections.
While many federal agencies get discounts on new hepatitis C medications, state prisons are among few government institutions that do not get those rebates, the study found. The federal prison system gets at least 24% off, a U.S. Senate Committee on Finance 2015 report observed. And the Department of Veterans Affairs may have a discount of 50% or more. Yet numerous state prison systems see discounts of only 10% or less. One prison system received no discount at all, paying the full $84,000 for Sovaldi and $94,500 for Harvoni.
“Gilead is turning a blind eye. State prisons don’t get an automatic discount by law, and they don’t have much bargaining power. Instead of offering lower drug prices, Gilead is just letting these patients get sicker,” said senior author Gregg Gonsalves, a lecturer at the Yale Law School and a director of GHJP. “If Gilead won’t cut the prices for state prisons, other steps may need to be taken.”