How Smart Public Policies Can Curb Hepatitis C

The coronavirus pandemic proved that the public health response to a large-scale crisis can literally mean the difference between life and death. That lesson can now be applied to a different public health issue – hepatitis C.

Caused by a virus that infects the liver, hepatitis C is a curable disease that, left untreated, can lead to cirrhosis, cancer and catastrophic liver damage. As many as 3.9 million people in the United States are infected, with about 75% of them unaware they carry the virus because it can be asymptomatic in the early stages. And it’s a growing problem: between 2009 and 2018, infection rates increased threefold.

The infection can be eradicated, though, with a comprehensive plan. A program based on innovative strategies to make treatment more affordable has already shown promise in Washington state, where Governor Jay Inslee aims to eliminate hepatitis C by 2030.

By establishing a partnership among state health agencies, a drug manufacturer of the curative hepatitis C therapy and community leaders, Washington’s plan has allowed stakeholders to “work in sync to test more people for hepatitis C, break down barriers to treatment and care, and expand access to affordable and effective antiviral medications.”

Washington’s hepatitis C elimination program, like a similar plan in Louisiana, employs an unconventional drug subscription program. The state contracts with a pharmaceutical company to obtain enough medication to treat state Medicaid beneficiaries as well as prisoners, a high-risk hepatitis C population.

The arrangement is sometimes called a Netflix model because, like the video streaming company, it’s based on a flat fee for an unlimited supply. In this case, the product is antiviral medication instead of movies. Australia began implementing the strategy in 2015. In five years, the approach was projected to have saved the nation AU $6.5 billion as compared to treating the same number of patients with conventional pricing.

Similar to Australia’s approach, the Washington state plan also focuses on at-risk groups. In addition, Washington state removed onerous barriers to treatment such as sobriety requirements and prior authorization. The state also doesn’t force patients to wait until their infection has reached an advanced stage before beginning treatment. As a result, declines in hepatitis C treatment rates due to the pandemic have been less severe in Washington than in other states, despite the challenges patients faced in maintaining their treatment regimen during COVID-19.

Most hepatitis C patients can be cured – if they have affordable access to the proper medication. By implementing programs like those in Washington and Louisiana, more states can expand access, improve the lives of patients and their families, and control the significant costs this disease imposes on society and the health care system.

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