While 1 in 10 state prisoners have been identified as having hepatitis C virus (HCV), just 1 in 100 of them are apparently receiving treatment at any given time.
The exorbitant cost of hep C drugs prevents access to treatment among this population, as does the fact that state prison systems do not receive the level of discounts from pharmaceutical companies that certain federal agencies do.
Publishing their findings in Health Affairs, researchers examined data from state departments of corrections covering the 49 states from which data were available. A total of 106,266 inmates, or 10 percent, were identified as having hep C around the beginning of 2015.
At about that time, 949, or 0.89 percent, of those prisoners with hep C were undergoing treatment for the virus.
Among the 31 state prison systems that provided information about drug expenditures, the median price they paid for 12 weeks of Sovaldi (sofosbuvir) treatment was $76,085, ranging from $3,413 in Connecticut to $84,000 in Michigan. The median price for 12 weeks of Harvoni (ledipasvir/sofosbuvir) was $63,509, ranging from $44,421 in Nevada to $94,500 in Michigan.
The list prices for 12 weeks of Gilead Sciences’ Sovaldi and Harvoni are a respective $84,000 and $94,500.
“Patients and prison officials alike want to cure hepatitis C infections,” A.T. Wall, director of the Rhode Island Department of Corrections and a coauthor of the study, said in a press release. “That requires financial resources and discounts we don’t have. What we desperately need are less costly drugs and more funding.”
While many state prison systems received only a 10 percent or smaller discount from pharmaceutical companies on hep C drugs, various federal agencies receive much larger discounts. The federal prison system receives discounts of 24 percent or greater and the Department of Veterans Affairs may receive discounts of 50 percent or greater.
“Gilead is turning a blind eye,” said study senior author Gregg Gonsalves, a lecturer at the Yale Law School and a director of the Global Health Justice Partnership at the university. “State prisons don’t get an automatic discount by law, and they don’t have much bargaining power. Instead of offering lower drug prices, Gilead is just letting these patients get sicker.”
The study authors recommend that state correctional departments collaborate with other governmental agencies to negotiate with pharmaceutical companies for greater discounts and also with health care facilities that provide medications that are discounted through the federal 340B Drug Discount Program.
Additionally, the authors recommend that state correctional departments make efforts to help inmates engage with health care providers in the community following release—which “can enhance the gains achieved by treating hepatitis C in prison.”
To read a press release about the study, click here.
To read the study abstract, click here.