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Expanding Access To Hepatitis C Treatment To All Who Need It

A cure exists for HCV. We can't let cost barriers to accessing life-saving medication impose a death sentence. The time is now to expand access to all who need it.
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Jeffrey thought the battles in his life were over. But following his service in Iraq as a combat solider, Jeffrey fought drug addiction and was later diagnosed with HIV. The next blow came when he learned that he was infected with the Hepatitis C virus (HCV), a blood-borne virus that can cause chronic liver disease, serious liver damage, and liver failure.

Jeffrey joined Amida Care -- New York's largest Medicaid special needs health plan for people living with chronic health conditions such as HIV/AIDS -- and was able to take control of his health through holistic care. Through Amida Care, Jeffrey was also able to access groundbreaking treatment that cured him of HCV in just 12 weeks.

Not everyone has this opportunity, however -- the high price of HCV medication keeps it out of reach for many. July 28 is World Hepatitis Day, which brings awareness to the goal of eliminating viral hepatitis as a public health threat by the year 2030. Without increased access to treatment, this goal cannot be achieved, and the health of those living with HCV or who are co-infected with HIV and HCV will remain at risk.

HCV is a silent epidemic. People can be infected with HCV for decades without experiencing symptoms. Compared with other age groups, people born between 1945 and 1965 are four to five times more likely to be infected with HCV. In accordance with New York State law, Baby Boomers in New York are now routinely offered the opportunity to be tested for HCV. The good news is that HCV can now be cured, with medications that are faster-acting than ever before and have no serious side effects.

As many as 25-30 percent of people living with HIV are co-infected with HCV. Those who are co-infected often have a weaker immune response to HCV compared to those who aren't co-infected. HIV co-infection more than triples a person's risk for liver disease, liver failure, and liver-related death from HCV.

Until recently, HCV was an incurable chronic infection for most HIV-positive people. However, with newly developed medication -- interferon (IFN)-free direct acting antiviral (DAA) regimens -- a recent study found that 95 percent of co-infected patients can be cured of HCV.

Amida Care has covered treatment for hundreds of HIV-HCV co-infected members. Of those who have already completed the drug regimen, 400 (98 percent) have been cured of HCV. Our ability to provide access to HCV medication and early treatment has helped hundreds of people like Jeffrey improve their health and live their lives HCV-free.

The availability of HCV treatment is an exciting medical development, and there have been important policy victories as well. Previously, New York State Medicaid covered Hepatitis C treatment only for those in advanced stages of liver disease or co-infected with HIV, but earlier this year, the state removed those restrictions. Several commercial insurance companies have lifted restrictions as well.

This is the right thing to do -- we can't stand by and let people die if we have the tools to save them. Unfortunately, the high price of these life-saving medications will continue to create barriers to care for people who could be cured.

In 2013, the profit margin for pharmaceutical companies ranged from 10 percent to 42 percent, with an average of 18 percent --factoring in the cost of research and development, which pharmaceutical companies cite as an explanation for the high price of the medication. The most frequently used drug costs $1,000 per pill, upward of $70,000 per 12- to 24-week course of treatment, totaling an estimated $3.5 billion in sales from April to June 2015.

Simply stated, prohibitive cost is preventing thousands of people from receiving life-saving treatment. It's time to make HCV medication available to all who need it. The upfront cost of the treatment also saves hundreds of thousands of dollars in long-term lifetime costs associated with infection.

Lower drug prices could be a win for all involved. If drug prices are lower, more people can access treatment and get well. Increased access means higher volume, which would in turn benefit pharmaceutical companies.

It's also important to ensure that those who receive treatment avoid re-infection. The goal, after all, is to see to it that once someone is cured, they are cured for life. We need to help people understand the importance of adhering to treatment and provide resources on safe sex practices and needle exchanges.

A cure exists for HCV. We can't let cost barriers to accessing life-saving medication impose a death sentence. The time is now to expand access to all who need it.