Fifteen countries are on track to fully eliminate the Hepatitis C virus by 2030, but the United States is not on that list.
Over the past few years, treatments for hepatitis C have advanced to the point that patients are cured of the disease after just 8-12 weeks of treatment. Unfortunately, many of the people most impacted by and at greatest risk of infection – the homeless, incarcerated and users of injected drugs – lack access to the ongoing care needed to fully banish the virus.
Improving Outreach Key to Elimination
Last year, the Biden administration proposed $11 billion to eliminating hepatitis C. Those resources supported renewed efforts to meet high-risk and infected individuals where they are for screening and on-the-ground treatment management.
Point-of-care testing at homeless encampments, shelters and in prisons, in particular, is critical as over 40% of hepatitis C cases go undiagnosed, often because patients lack access to screening. Testing is a crucial first step to eventually eliminating hepatitis C. The World Health Organization already recommends such testing to improve diagnoses and treatment compliance for tuberculosis, COVID-19 and HIV-AIDS. Adding hepatitis C would be worthwhile.
Just as new efforts to expand testing are underway, so too are innovative approaches to help patients complete treatment. One such strategy, the “Netflix model” that was pioneered in Louisiana, pays manufacturers of the antiviral medication a subscription-style fee for treatment for an unlimited number of publicly-insured patients.
Curative Treatment Cornerstone of National Plan
While several states have been experimenting with their own models, full elimination of hepatitis C will require a coordinated, nationwide plan.
“It is time we have bipartisan support for this issue that affects millions of Americans,” according to Robert Gish, MD, a hepatologist from San Diego, California. “No patient or country should be left behind in the goal of curing hepatitis C for all.”
Proponents of a universal treatment strategy claim $8 billion a year could identify and treat the majority of cases. Given that hepatitis C costs the nation an estimated $11 billion annually, investing in curative treatment makes good fiscal sense.
The price for a complete cycle of medication has dropped to around $24,000, or roughly the same price as a three-day hospital stay. Initiating curative treatment early substantially lowers rates of liver disease and transplant, which are many times more expensive than the treatment.
A penny of prevention is worth a pound of cure, but Congress has, so far, failed to put the national plan into action.
