By: Marcus J. Hopkins, Blogger
The Community Access National Network (CANN) will be hosting a roundtable at the headquarters of the Pharmaceutical Research and Manufacturers of America (PhRMA) on Thursday, May 11th, 2017, on the topic of Hepatitis C (HCV) in Incarcerated Populations. The roundtable will focus on various aspects of treated HCV in prison and jail settings, including the Constitutional requirement that all inmates receive treatment, as well as various barriers that prevent inmates from receiving screening and treatment.
Current estimates indicate that between 10-35% of inmates are infected with HCV, and that roughly half of those inmates don’t know that they’re infected. These estimates are, however, limited by inconsistent or non-existent screening protocols, reporting requirements, and various bureaucratic hurdles that prevent inmates from being screened. Furthermore, there are no penalties in place that hold prison and jail systems accountable for failing to screen inmates, which often results in costly lawsuits.
The Federal Bureau of Prisons released a new set of screening guidelines for HCV in October 2016, which included the recommendation that all prisons and jails adopt an “Opt-Out” screening process (Federal Bureau of Prisons, 2016). This strategy requires that HCV screening becomes part of a routine practice, and that inmates must provide “informed refusal” in order not to be screened. This strategy would be instrumental in combating the HCV epidemic running rampant among inmate populations, as well as for data gathering purposes.
Implementing this strategy across all prisons and jails in the U.S. in a difficult proposal, in no small part because it will be expensive. What makes it so expensive is that screening, itself, isn’t cheap – at least not the confirmatory tests; additionally, if prisons and jails discover that an inmate has HCV, or any other life-threatening illness, they are required under the 8th Amendment of the U.S. Constitution to treat that inmate’s illness (Estelle v. Gamble). That last part can cost prison systems tens of thousands of dollars fear each infected inmate – costs that will explode pharmacy and healthcare budgets in the short-term, but will save money in the long-term.
Furthermore, prisons appear to be extremely inconsistent about what prices they pay for drugs. The Wall Street Journal (WSJ) published a report in September 2016 per-patient cost paid by state prisons to treat HCV using Gilead’s Harvoni: the prices ranged from $46,021 in North Dakota to $91,014 in Georgia (Loftus & Fields, 2016). These numbers indicate the need for more price stabilization in the U.S. prison systems, or at the very least, consolidated price negotiation.
While the roundtable is open to the public, seating is limited. Interested parties can sign up for the event at the following address: http://tiicann.org/events.html
- Estelle v. Gamble, 429 U.S. 97 (1976). Retrieved from: https://www.law.cornell.edu/supremecourt/text/429/97
- Federal Bureau of Prisons. (2016, October). EVALUATION AND MANAGEMENT OF CHRONIC HEPATITIS C VIRUS (HCV) INFECTION [Federal Bureau of Prisons – Clinical Guidance; October 2016). Washington, DC: Federal Bureau of Prisons: Health Management Resources: Clinical Practice Guidelines. Retrieved from: https://www.bop.gov/resources/pdfs/hepatitis_c.pdf
- Loftus, P. & Fields, G. (2016, September 12). High Cost of New Hepatitis C Drugs Strains Prison Budgets, Locks Many Out of Cure. New York, NY: The Wall Street Journal. Retrieved from: https://www.wsj.com/articles/high-cost-of-new-hepatitis-c-drugs-strains-prison-budgets-locks-many-out-of-cure-1473701644
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.