New Hepatitis C Drugs Are Very Costly And Unavailable To Many State Prisoners

Abstract

Prisoners bear much of the burden of the hepatitis C epidemic in the United States. Yet little is known about the scope and cost of treating hepatitis C in state prisons-particularly since the release of direct-acting antiviral medications. In the forty-one states whose departments of corrections reported data, 106,266 inmates (10 percent of their prisoners) were known to have hepatitis C on or about January 1, 2015. Only 949 (0.89 percent) of those inmates were being treated. Prices for a twelve-week course of direct-acting antivirals such as sofosbuvir and the combination drug ledipasvir/sofosbuvir varied widely as of September 30, 2015 ($43,418-$84,000 and $44,421-$94,500, respectively). Numerous corrections departments received smaller discounts than other government agencies did. To reduce the hepatitis C epidemic, state governments should increase funding for treating infected inmates. State departments of corrections should consider collaborating with other government agencies to negotiate discounts with pharmaceutical companies and with qualified health care facilities to provide medications through the federal 340B Drug Discount Program. Helping inmates transition to providers in the community upon release can enhance the gains achieved by treating hepatitis C in prison.

Trends and mental health correlates of nonmedical opioid use among criminal justice-involved African American men

“…This finding also suggests African American men involved in the criminal justice system may encounter unique sociodemographic and psychosocial risk factors, which are not being captured in extant literature, conceptualizing NMOU as a ‘White problem’ in suburban (Cicero et al, 2014) and rural areas (Love et al, 2016). Consistent with the availability-proneness theory (Smart, 1980), these psychosocial risk factors may include: re-entry stress (Baron et al, 2013; Lee et al, 2017), mental illness (Broz & Oullet, 2010), homelessness (Nyamathi et al, 2014), and poverty (Bright, 2012). In the absence of adequate resources, these psychosocial stressors may persist and increase their proneness to engage in substance use, criminal behavior (Mahaffey et al, 2017), and consequently, involved in the criminal justice system; resulting in a potentially cyclical pattern of substance use (Baillargeon et al, 2009).…”

Hepatitis C Testing and Patient Characteristics in Washington State's Prisons Between 2012 and 2016

“…Facilities offering testing often follow a risk-based approach and surveys have shown that approximately 40% of state prison facilities routinely test for HCV. 5–8 …”

Drug Purchasing Strategies to Treat People With Hepatitis C in the Criminal Justice System

“…However, very few detainees receive HCV treatment during incarceration. 4 Treatment is limited, in part, by case identification. National guidelines now recommend universal opt-out screening; however, this is not being performed in most states.…”

“…National guidelines now recommend universal opt-out screening; however, this is not being performed in most states. 4 Furthermore, not all correctional systems have the infrastructure in place to provide HCV treatment. The most significant barrier, however, is the budgetary challenge associated with costs that supersede overall correctional health care budgets in certain states.…”