Tag Archives: HIV

Georgia, Idaho, and North Dakota Legalize Syringe Services Programs

By: Marcus J. Hopkins, Policy Consultant

Both the Georgia and Idaho state legislatures have passed laws legalizing Syringe Services Programs (SSPs) in 2019 (Copeland, 2019; Mansoor, 2019; Horn, 2019). These states are just the latest to take measures legalizing SSPs in the wake of the 2015 HIV outbreak amongst People Who Inject Drugs (PWIDs) in Scott County, Indiana. Other state legislatures considering SSP legalization in their 2019 legislative sessions include Florida (Florida Daily, 2019), Iowa (Filter, 2019), and Missouri (Dohrman, 2019).

(You can find out which states have at least one operating SSP in the Community Access National Network’s monthly publication, The HIV/HCV Co-Infection Watch in the Harm Reduction section)

SSP funding on the Federal level was legalized in 2016 in response to the aforementioned 2015 outbreak under The Consolidated Appropriations Act of 2016 which gives states and local communities, under limited circumstances, the opportunity to use Federal funds to support certaincomponents of SSPs (Centers for Disease Control and Prevention, 2018). How Federal funds can be used is laid out in a 2016 Health and Human Services (HHS) guidance (HHS, 2016).

Medical technician counting needles.

Photo Source: Daily Beast

The efficacy of SSPs has long been established – numerous studies conducted since the 1980s, both in the U.S. and internationally, have shown significant decreases in new HIV and Viral Hepatitis infections amongst PWIDs and overall in areas where SSPs are present. Despite their proven efficacy, SSPs remain controversial, particularly in the U.S., where drug addiction is often viewed less as a disease to be treated, and more as a moral failing to be punished. Around the country, SSPs face extreme pressure and protests from local communities who view SSPs as nuisances that subsidize, promote, and validate drug abuse, rather than for the services they provide.

SSPs provide not only clean syringes in exchange for used ones, they often provide clinical healthcare services, access and referrals to substance abuse treatment programs, STD/STI testing, and linkages to other social services programs by helping clients enroll in programs like Medicaid and SNAP if they are eligible. These services, however, are often overlooked by opponents of these programs who argue that SSPs increase biohazardous needle waste, attract “unsavory” elements (by whom they mean “drug addicts”) into presumably otherwise “decent” neighborhoods, and encourage clients to engage in illicit drug use.

In my experience, arguing with or against those who oppose SSPs is often a Sisyphean effort – those who are unwilling to allow that evidence disproves their deeply held beliefs are no more likely to change their opinions than they are to sprout wings and migrate South for the winter. More often than not, programs that are effective – such as those in Charleston, WV and Orange County, CA – are met with staunch resistance with connections to those in power or who are willing to spend unlimited resources to maintain the edifice that “…everything was all right until this needle exchange showed up, and now our community has gone to Hell!” What makes it worse is that those who oppose SSPs frequently have no alternative solutions to the problem of increasing rates of new HIV, Hepatitis B, and Hepatitis C infections related to Injection Drug Use, other than, “Well, they should just stop using.”

This kind of thinking is emblematic of the American Way of Dealing with Social Problems: if we pretend hard enough that the problem doesn’t exist, maybe we can make the problem not exist. We’ve been trying that approach for nearly four decades, now, and the problems haven’t gone away; they only gotten worse. Until such time as those who oppose evidence-based solutions in favor of punitive solutions (for which they are always unwilling to pay additional taxes to fund those efforts) finally remove their heads from the sand, we will continue to fail at stemming the increase in infectious diseases spread via Injection Drug Use.

References:

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Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.

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Minnesota the Latest State to Lose Correctional HCV Lawsuit

By: Marcus J. Hopkins, Policy Consultant

Minnesota inmates living with Hepatitis C (HCV) are the latest to win access to curative HCV treatment by way of a costly (to the state) class-action lawsuit (Associated Press, 2019). This latest settlement requires the Minnesota Department of Corrections (MDOC) to screen (more on that, in a minute) all inmate for HCV, provide immediate treatment to all inmates with an advanced stage of the disease or those who have co-morbidities (e.g. – HIV co-infection), and reevaluate every inmate who is denied treatment every six months for possible approval (AP).

Minnesota Department of Corrections

Photo Source: kstp.com

Prior to the terms of this settlement, MDOC only tested inmates for HCV “on request,” meaning that inmates had to specifically request to be tested for the disease and prison officials could approve or deny that request. This type of testing protocol is often used by state DOCs to avoid being legally required to treat inmates for health conditions, which they are Constitutionally required to do under the 8thAmendment’s “cruel and unusual punishment” clause. By refusing to test, prisons can plausibly deny that they’re deliberately refusing to treat inmates’ conditions, because they “don’t know” that inmates are infected.

Minnesota is just the latest state whose DOC has failed to convince state and Federal judges of their “it’s just too expensive” argument. Other states, including Florida, California, , and Massachusetts, have failed to provide a reasonable excuse for why the lives of human beings are not worth the cost to treat their illnesses. These class-action suits have, for many years, now, been the only means for inmates to receive the treatment to which they are Constitutionally guaranteed.

This topic and more will be addressed at the Community Access National Network’s 3rdAnnual Community Roundtable on HCV in Correctional Settings. The event will be held on April 17th, 2019, and you can sign up to attend here: http://tiicann.org/events.html#041719

Attendance is free, but space is limited. In addition to in-person attendance, we will also offer teleconferencing for those who are unable to make the meeting in person. Those interested in that option must still register, and more information will be made available closer to the date of the Roundtable.

References:

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Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.

 

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Abuse-Deterrent Prescription Opioids Likely Worsened Both Opioid and HCV Epidemics

By: Marcus J. Hopkins, Policy Consultant

Three years ago, HEAL Blog wrote about National Public Radio’s (NPR’s) new program, “Embedded,” and their first episode, “The House,” in which reported Kelly McEvers visits Austin, Indiana, and witnesses numerous people abusing the supposedly abuse-deterrent (and now discontinued) prescription opioid drug, Opana (Endo Pharmaceuticals). In this segment, the subjects – including a former nurse – melt off the protective plastic coating and liquify the drug, strain it through mesh to remove the melted plastic, mixing in some water to dilute the drug, and injecting the drug directly into their blood streams.

“Abuse-Deterrent” drugs, including prescription opioids and prescription stimulants (e.g. – Ritalin), came about around the end of the 2000s in response to a growing number of lawsuits alleging that pharmaceutical products were becoming more powerful, more addictive, and easier to abuse. These “deterrents” consistently involved the creation of time-released medications concealed in plastic that would slowly melt inside the body and release a consistent dosage over time. At the time, these new formulations were heralded as the answer to prescription drug abuse – they were harder to abuse, which would lead to fewer people becoming addicted!

Man holding needle

Photo Source: U.S. News & World Report

Except, that didn’t happen. The drugs were already incredibly powerful and addictive, and those who previously abused the non-abuse-deterrent versions either found ways, like the one mentioned above, to get around these deterrents, or switched over to less expensive illicit drugs like heroin and methamphetamine. As with every substance addiction, once you get started, it is incredibly hard to stop, and addicts will inevitably find some way to satisfy their addictions.

These abuse-deterrent reformulations led to an increase in Injection Drug Use (IDU) which, after a brief lapse during the 1980s and 90s thanks to the HIV epidemic, has made a roaring comeback, particularly in areas hard hit by economic hardships, unemployment, and relative isolation from more urban areas. While the heroin epidemic of the 1970s was largely contained within urban settings, this new epidemic hit primarily in rural and suburban parts of the U.S. – areas where physical labor (e.g. – manufacturing and mining) led to chronic pain issues which were being addressed with these highly addictive, but highly effective prescription opioid drugs.

New research published in Health Affairs this month found evidence that supports what those of us on the ground have been saying for years: abuse-deterrent drugs were making the problem worse. Not only did they increase the number of people switching from prescription opioids to heroin, they also led to an increase in new Acute Hepatitis C (HCV) infections as a result of IDU.

This study looked specifically at the 2010 reformulation of OxyContin (Purdue Pharma). Between 2010 and 2015, there was a more than 40% drop in the abuse of OxyContin. Prior to this reformulation, HCV infection rates were comparable between above- and below-median misuse states (meaning literal states, and not the state of using the drugs); beginning in 2011 – the first full year after the reformulation hit the market – the gap between those states began to widen (Powell, et al, 2019). States with above-median misuse of OxyContin saw a 222% increase in HCV infections after the reformulation, while states with below-median misuse of OxyContin saw only a 75% increase over the same period. The researchers found that much of the increased infection rate was caused by people switching from the harder-to-abuse, move expensive reformulation over to cheaper and easier to procure heroin, which has a higher rate of injection than reformulated OxyContin.

Essentially, those states that had a high rate of OxyContin abuse saw massive increases in HCV infection rates, while those with a low rate of abuse still saw an increase, but ones that were significantly lower.

Does this mean that efforts to prevent prescription opioid abuse should be halted? Absolutely not! What it does mean is that our governments – Federal, state, and local – need to stop treating health crises as isolated incidences that can be solved with a single strategy. As with every healthcare-related issue, there is no singular “cause” that can be solved with a singular “cure.” Every action taken – whether that be decreasing access to prescription opioid drugs or closing Syringe Exchange Services programs – has both positive and negative consequences and combating health issues will always require multi-pronged approaches to anticipate and deal with those issues.

Moreover, outside of just “healthcare” responses, such as increasing access to clean syringes, changing HIV/Viral Hepatitis testing protocols to be universal, or increasing access to Medication-Assisted Treatment, addressing healthcare issue also requires additional changes, such as increasing access to job placement/training services, affordable housing assistance, and other wraparound services that can help reduce the conditions that often increase the likelihood that someone will begin abusing pharmaceutical/illicit drugs.

The researchers also reached this conclusion, so…it is not just Marcus being crazy and radical.

References:

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Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.

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Study Findings Suggest Universal Hepatitis Screening for Cancer Patients

By: Marcus J. Hopkins, Policy Consultant

A study published in The Journal of the American Medical Association Oncology (JAMA) found that many newly-diagnosed cancer patients may be unaware of being infected with Hepatitis B (HBV), Hepatitis C (HCV), and/or HIV (Barrett, 2019). The study examined data from 3,051 patients who enrolled between 2013 and 2017 who received blood tests to determine their HBV, HCV, and HIV status, and is the largest study to date of these viruses in cancer patients.

The Journal of the American Medical Association

Photo Source: JAMA

Of the 3,051 participants, 6.5% of patients had HBV (0.6% with a Chronic HBV infection), 2.4% had HCV, and 1.1% had HIV. Of these patients, 87.3% of HBV-infected, 42.1% of Chronic HBV-infected patients, and 31% of HCV-infected patients were undiagnosed prior to this study’s screening. Researchers noted that these findings comport with infection rates in the general population (Ramsey, et al., 2019).

Most concerning is that many of those who were newly diagnosed with HBV and HCV had no identifiable risk factors for infection (e.g. – injection drug use). The researchers concluded that universal Viral Hepatitis screening of cancer patients may be warranted in order to prevent viral reactivation and other adverse clinical outcomes.

HEAL Blog has been calling for universal screening for years, not only for cancer patients, but for the general population. Numerous studies have found that routine rapid HCV testing (particularly in communities where drug use is prevalent) is incredibly cost-effective in both younger generations and older generations. Current CDC testing recommendations for HCV are incredibly narrow, focusing primarily on the Birth Cohort (1945-1965) and Injection Drug Users. Acute HCV infection data, however, indicate that people aged 18-55 are currently bearing the burden of new HCV infections. With these data in mind, it would be a smart move to expand those testing recommendations.

Undiagnosed and untreated HBV and HCV can both lead to serious health consequences; without universal screening, we will continue to see the hepatic and extra-hepatic impacts of Viral Hepatitis manifest in younger generations. These consequences are not only difficult to endure for patients, but are also incredibly expensive to treat. It is time for the CDC to welcome itself into the 21stCentury and expand screening to all adults.

References:

  • Ramsey, S.D., Unger, J.M., Baker, L.H., et al. (2019, January 17). Prevalence of Hepatitis B Virus, Hepatitis C Virus, and HIV Infection Among Patients With Newly Diagnosed Cancer From Academic and Community Oncology Practices. The Journal of the American Medical Association Oncology. Published online January 17, 2019. DOI: doi:10.1001/jamaoncol.2018.6437
  • Barrett, J. (2019, January 23). Study: Many Cancer Patients Unaware of Hepatitis Infections. Cranbury, NJ: Pharmacy & Healthcare Communications, LLC: Specialty Pharmacy Times: News. Retrieved from: https://www.specialtypharmacytimes.com/news/study-many-cancer-patients-unaware-of-hepatitis-infections

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Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.

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Restricting Access to HCV Treatment May Decrease Survival in HIV Co-Infection

By: Marcus J. Hopkins, Policy Consultant

A study published in Clinical Infectious Diseases has found that restricting access to Hepatitis C (HCV) Direct-Acting Antivirals (DAAs) may decrease survival rates among people co-infected with HIV (Breskin, et al., 2019). These findings comport with similar findings published in 2017 that found co-infection with both Hepatitis B (HBV) and HCV in HIV patients is significantly associated with increased all-cause and liver-related mortality rates (Thornton, et al, 2017).

On the cover: There they go, plucked, etching, burnished aquatint and drypoint, 1797–98, by Francisco de Goya (Spanish, 1746–1828). National Gallery of Art, Washington, D.C. Art Resource, New York, NY. Reproduced with permission. Like several prints from Los Caprichos (caprices), this image refers to a pun: the Spanish word desplumar, “to pluck”, has the same connotation as “to fleece” in English. These prostitutes are shooing out customers they have fleeced, to make room for new ones. Their bald customers, in a further play on desplumar, may also mean that they were suffering from syphilis, associated with hair loss, for syphilis was a common disease contracted from prostitutes. (Mary & Michael Grizzard, Cover Art Editors)
Photo Source: Clinical Infectious Diseases
[On the cover: There they go, plucked, etching, burnished aquatint and drypoint, 1797–98, by Francisco de Goya (Spanish, 1746–1828). National Gallery of Art, Washington, D.C. Art Resource, New York, NY. Reproduced with permission. Like several prints from Los Caprichos (caprices), this image refers to a pun: the Spanish word desplumar, “to pluck”, has the same connotation as “to fleece” in English. These prostitutes are shooing out customers they have fleeced, to make room for new ones. Their bald customers, in a further play on desplumar, may also mean that they were suffering from syphilis, associated with hair loss, for syphilis was a common disease contracted from prostitutes. (Mary & Michael Grizzard, Cover Art Editors)]

 

Essentially, people living with HIV who are co-infected with HBV and/or HCV will die more frequently than those mono-infected with HBV and/or HCV if they do not receive treatments for their disease.

Both studies come to the same conclusions: we need to increase primary prevention efforts to prevent co-infection with Viral Hepatitis (VH) from ever occurring, and we need to “thoughtfully revise access policies” (Breskin).

Isn’t that pleasant? “Thoughtfully revise” …why, if one listens closely enough, one might hear birds chirping and a babbling brook, so peaceful is this image.

Forgive my cynicism, but haven’t we really gotten beyond the point of politely asking for better access?

HCV HIV Co-Infection

Photo Source: Project Inform

Since DAA drugs hit the market in 2013, marginalized populations have had to fight tooth and nail for better access to these drugs – it has taken dozens of lawsuits, both of the Class-Action and Civil varieties, to force state agencies and institutions to agree to open up access to these medications. States all around the U.S. have entered into settlements with Medicaid recipients and inmates; a handful of other states have chosen to fight litigation as high as they can, and virtually every ruling goes against them, forcing them to pony up the money to treat high-risk populations.

Perhaps these types of polite requests work in other, more civilized nations, where healthcare is considered a human right, rather than a cash cow to be milked dry. Here, in the U.S., however, it takes gumption and the willingness to fight.  This has been true of HIV treatment; it is true of HCV treatment. And make no mistake: it will be a fight to gain open access to these medications.

In the meantime, until co-infected patients merit reliable access to HCV DAA drugs, they will continue to die faster than our mono-infected peers; they will continue to languish on wait lists, waiting for their livers to fail and suffer the extra-hepatic (non-liver-related) co-morbidities associated with untreated HCV. Maybe, if they ask politely, they will be given an extra comfy gurney upon which to do so.

References:

  • Breskin, A., Westreich, D., Hurt, C.B., Cole, S.R., Hudgens, M.G., Seaberg, E.C., Thio, C.L., Tien, P.C., & Adimora, A.A. (2019, January 07). The effects of hepatitis C treatment eligibility criteria on all-cause mortality among people with HIV. Clinical Infectious Diseases(ciz008). DOI: https://doi.org/10.1093/cid/ciz008
  • Thornton, A.C., Jose, S., Bhagani, S., Chadwick, D., Dunn, D., Gilson, R., Main, J., Nelson, M., Rodger, A., Taylor, C., et al. (2017, November 28). Hepatitis B, hepatitis C, and mortality among HIV-positive individuals. AIDS 31(18), 2525-2532. DOI: https://dx.doi.org/10.1097%2FQAD.0000000000001646

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Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.

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What We Missed in December 2018

By: Marcus J. Hopkins, Policy Consultant

The month of December has tended to be a month of reflection for HEAL Blog – one where we look back on the year we have survived and all the successes and failures that came along with that. While we are doing all that reflecting, however, the rest of the world continues to operate, and news continues to be made. This first HEAL Blog post of 2019 will take a moment to look at some of those stories:

Looking Back

Photo Source: empowerla.org

  • Florida Failing to Treat Inmates

Florida, as per usual, made the news for failing to provide treatment for inmates currently incarcerated by the Florida Department of Corrections (FDOC). This time, two inmates at different correctional facilities have filed complaints against both FDOC, and two of FDOC’s private contractors – the GEO Group and Correct Care Solutions – alleging that the accused parties have violated their civil rights by denying these inmates the “best recognized treatment” for Hepatitis C (HCV).

FDOC has consistently failed to provide inmates with treatment that is the current standard of care, arguing repeatedly in various court proceedings that the cost makes doing so untenable. In this case, wrangling in the private contractors for failing to provide treatment despite the legal requirement (as well as a court ordered preliminary injunction ordering FDOC to do so that has been in place since November 2017) is an interesting take, suggesting that the contractors should be required to comply with the law/court order, regardless of whether or not they’re instructed to do so by FDOC (Schweers, 2018).

We will continue to follow this case s it progresses.

  • New Strains of HCV Found in Sub-Saharan Africa

Research published in Hepatology indicates that three new strains of the HCV virus were found in sub-Saharan Africa (SSA) after examining data from the largest population study of HCV. While currently HCV Direct Acting Antivirals (DAAs) have proven effective in treating HCV in most countries around the world, the presence of these new strains indicate that the regimens may not be as effective in treating strains specific to SSA.

Similar issues exist with the treatment of HIV-2 – a strain of HIV that is concentrated in and around West Africa and is more difficult to treat because it is intrinsically resistant to Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs).

The researchers and collaborators looking at these data have expressed the urgent need for more trials to be conducted in SSA in order to ensure that forthcoming DAAs are able to successful treat HCV in the region (Davis, et al., 2018).

  • Potential HIV/HBV/HCV Exposure at New Jersey Surgery Center

Here is yet another story of potential exposure to HIV, Hepatitis B (HBV), and HCV as a result of “lapses in infection control procedures,” this time in Saddle Brook, New Jersey. The exposure risk includes anyone who had procedures at the HealthPlus Surgery Center between January 2018 and September 07, 2018 (Eyewitness News, 2018a). The exposure alert and recommendation for testing includes an estimated 3,800 patients.

After the initial report on December 25thwas filed, ABC7 New York did a follow-up story on December 31stin which they detailed the nature of these lapses in protocol. These lapses include poor drug storage, an outdated infection control plan, and “unacceptable sterilization practices, according to a new state report” (Eyewitness News, 2018b).

From improperly cleaned and disinfected operating rooms, to rust-like stains on improperly stored and/or sterilized surgical equipment, to an undisinfected, blood-stained sheet left unattended on a stretcher in a hallway, the center seems to have gone above and beyond in their efforts to expose as many patients as possible to as many infectious diseases as possible. These myriad problems were so pervasive, the center was forced to shut down for three weeks in September after the New Jersey Department of Health received a complaint.

So far, one person has tested positive and a lawsuit has been filed. HEAL Blog will continue to monitor this story for additional developments in 2019.

As we sally forth into 2019, HEAL Blog will continue to provide weekly coverage of the latest news in Viral Hepatitis, and we look forward to celebrating our sixth anniversary in October of this year.

References:

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Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.

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The State of Hepatitis C Coverage in America – Part 2: Medicaid

HEAL Blog is the recipient of the ADAP Advocacy Association’s 2015-2016 ADAP Social Media Campaign of the Year Award
By: Marcus J. Hopkins, Blogger

In our final HEAL Blog post of 2018, we will be continuing from last week our analysis of Hepatitis C (HCV) coverage in the United States. While this was originally designed to be Part 2 of a three-part series, the decision was made to cut this month short by whittling that down to just two posts for the month of December.  As such, this final HEAL Blog will focus on the state of Medicaid coverage for HCV Direct Acting Antivirals (DAAs). Read Part 1, The State of Hepatitis C Coverage in America – Part 1: ADAP.

HIV/HCV Co-Infection Watch

HIV/HCV Co-Infection Watch

At the time of our inaugural report in January 2015, only 38 state Medicaid programs offered coverage for HCV DAAs. Even then, access to these treatments was severely limited by numerous onerous Prior Authorization pre-requisites, primarily those which required patients to suffer moderate-to-extreme liver decomposition and scarring – scores of F3 or F4 – before even being considered for treatment approval. Other pre-requisites include(d) sobriety requirements, drug use prohibitions, enrollment in recovery treatment programs, and numerous appeals.

In addition to these pre-requisites, both the states that ostensibly offered coverage and those that did not openly argued that made no bones about restricting or refusing coverage based on cost. So overt was their argument and pervasive the problem that the Centers for Medicare & Medicaid Services (CMS) issued a guidance letter to every state Medicaid program specifically stating that cost considerations “…should not result in the denial of access to effective, clinically appropriate, and medically necessary treatments using DAA drugs for beneficiaries with chronic HCV infections” (Center for Medicaid and CHIP Services, 2015).

With the CMS guidance was announced in November 2015, by August 2016, every state Medicaid program had expanded their coverage to include HCV DAAs. Since August 2016, every state has continued to offer coverage…again, ostensibly. Over time, several states have either reduced or eliminated the F-score requirements for treatment consideration, as well as removing other pre-requisites, the most recent of which was Oregon (this has not been officially announced, yet, so the citation is forthcoming).

As we have covered numerous times since Mavyret’s (AbbVie) August 2017 debut (including in last week’s HEAL Blog), the introduction of the drug at a remarkably lower Wholesale Acquisition Cost relative to other available DAAs allowed many programs to begin reducing or eliminating restrictions altogether. And, again, looking forward to the January 2019 release of Gilead’s authorized generic versions of their breakthrough drugs, Harvoni and Epclusa, the cost of HCV treatment continues to decline in part because of innovation, but mostly, because of AbbVie’s 2017 salvo with the lowest priced DAA on the market.

There are, however, newer DAAs in the pipeline. 2018 was the first year since 2013 in which a new HCV DAA was not released into the U.S. market. With prices demonstrably lower than the initially unconscionably high prices in 2013, it is unclear whether pharmaceutical companies will stay in the HCV game – Janssen, makers of the now-discontinued Olysio, the once-companion drug to Gilead’s Sovaldi – bowed out of game at the end of 2017, pulling Olysio from the shelves in May of this year. Companies that once assumed that their HCV drugs would enter into a highly competitive, high-priced market are coming up against incredibly popular and effective drugs that cost roughly 1/3 of the original DAAs. That difference in entry price does not bode well for newcomers or new drugs hoping to gain a foothold in the market.

The Community Access National Network will continue to monitor the state of HCV coverage in the U.S. Until next year, we wish you and yours the Happiest of Holidays and an even Happier New Year.

References:

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Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.

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