Responding to Hepatitis C through the Criminal Justice System

Rich, Josiah D.; Allen, Scott; Williams, Brie

doi:10.1056/nejmp1311941

Cited by 47 publications

(40 citation statements)

References 4 publications

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“…Short-course, easily tolerated, highly curative (albeit expensive) treatments have arrived. 16,17 The availability of these new treatments is critical, as complications in long-term hepatitis C infection (liver failure, hepatocellular carcinoma, and mortality) are rising dramatically, and are expected to continue to rise. 18 Since the prisoner population has a high burden of hepatitis C, and because most prisoners will eventually return to our communities, successful treatment options in the criminal justice system could have a tremendous impact on public health at large (Figs.…”

Section: Hepatitis Cmentioning

confidence: 99%

“…Undoubtedly, this cost impediment to treatment will need to be addressed, perhaps through a state or federal carve-out funding mechanism that allows for bulk purchasing. 17 Once this issue is addressed, since over 30% of all persons with hepatitis C are incarcerated at some point, correctional healthcare should be held to a standard that exceeds community standards, 19 including surveillance and treatment for willing patients in order to stem the epidemic and to improve our public health, both inside and outside correctional institutions. With such a high density of infection, correctional medicine can set the standard for population-based hepatitis C treatment.…”

Section: Hepatitis Cmentioning

confidence: 99%

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The Need for Higher Standards in Correctional Healthcare to Improve Public Health

2014

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Section: Hepatitis Cmentioning

confidence: 99%

Section: Hepatitis Cmentioning

confidence: 99%

The Need for Higher Standards in Correctional Healthcare to Improve Public Health

2014

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“…21 This is typically interpreted to mean that incarcerated individuals should receive care comparable to the standard for persons with access to care in the community. 22 Clear treatment standards for hepatitis C have been lacking due to the risks associated with prior therapies and inadequate treatment responses. Prior to 2011, treatment was limited to pegylated-interferon (IFN) and ribavirin (RBV) with cure rates often less than 50 % for patients with the most common genotype, genotype 1, with significant associated toxicities.…”

Section: Introductionmentioning

confidence: 99%

A Budget Impact Analysis of Newly Available Hepatitis C Therapeutics and the Financial Burden on a State Correctional System

et al. 2015

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Hepatitis C virus (HCV) infection continues to disproportionately affect incarcerated populations. New HCV drugs present opportunities and challenges to address HCVin corrections. The goal of this study was to evaluate the impact of the treatment costs for HCV infection in a state correctional population through a budget impact analysis comparing differing treatment strategies. Electronic and paper medical records were reviewed to estimate the prevalence of hepatitis C within the Rhode Island Department of Corrections. Three treatment strategies were evaluated as follows: (1) treating all chronically infected persons, (2) treating only patients with demonstrated fibrosis, and (3) treating only patients with advanced fibrosis. Budget impact was computed as the percentage of pharmacy and overall healthcare expenditures accrued by total drug costs assuming entirely interferon-free therapy. Sensitivity analyses assessed potential variance in costs related to variability in HCV prevalence, genotype, estimated variation in market pricing, length of stay for the sentenced population, and uptake of newly available regimens. Chronic HCV prevalence was estimated at 17 % of the total population. Treating all sentenced inmates with at least 6 months remaining of their sentence would cost about $34 million-13 times the pharmacy budget and almost twice the overall healthcare budget. Treating inmates with advanced fibrosis would cost about $15 million. A hypothetical 50 % reduction in total drug costs for future therapies could cost $17 million to treat all eligible inmates. With immense costs projected with new treatment, it is unlikely that correctional facilities will have the capacity to treat all those afflicted with HCV. Alternative payment strategies in collaboration with outside programs may be necessary to curb this epidemic. In order to improve care and treatment delivery, drug costs also need to be seriously reevaluated to be more accessible and equitable now that HCV is more curable.

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“…Incarcerated individuals are susceptible to communicable diseases such as Hepatitis-C (HCV) and Human Immunodeficiency Virus (HIV) and have higher rates of HIV and HCV than the general population (HCV: 17% vs. 1%); HIV: 1.6% vs. 0.5%) [1,2]. US Veterans are no exception, and are at higher risk for HIV and HCV than the general population, and have significant incarceration rates, comprising approximately 10% of all inmates [3].…”

Section: Introductionmentioning

confidence: 99%

An Evaluation of Post-Incarceration Linkage to Care for HIV/Hepatitis C Infected Veterans in Los Angeles County

Anaya¹,

Solomon²,

Saifu³

2015

J AIDS Clin Res

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Responding to Hepatitis C through the Criminal Justice System

Cited by 47 publications

References 4 publications

The Need for Higher Standards in Correctional Healthcare to Improve Public Health

The Need for Higher Standards in Correctional Healthcare to Improve Public Health

A Budget Impact Analysis of Newly Available Hepatitis C Therapeutics and the Financial Burden on a State Correctional System

An Evaluation of Post-Incarceration Linkage to Care for HIV/Hepatitis C Infected Veterans in Los Angeles County

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