According to a recent study, access to highly effective medications for hepatitis C has been limited in the United States for the past decade. These drugs, known as direct-acting antivirals, have been hailed as significant achievements in modern medicine due to their ease of use, minimal side effects, and cure rate of around 95%.
When these therapies were approved in 2013, there was hope that hepatitis C, which was the leading cause of liver transplants in the US at the time, could be eradicated. Egypt, a country with a high prevalence of hepatitis C, has successfully eliminated the disease through widespread access to these medications.
However, in the United States, the situation highlights a major disparity in the healthcare system, where American patients often struggle to afford the high prices of prescription drugs, paying more than double the amount compared to patients in other wealthy countries.
Dr. Jonathan Mermin, the director of the National Center for HIV, Viral Hepatitis, STD, and TB Prevention at the US Centers for Disease Control and Prevention, emphasized that nearly 15,000 Americans die from hepatitis C each year, deaths that could have been prevented. The study published in the CDC’s Morbidity and Mortality Weekly Report sheds light on the significant disparities in access to hepatitis C therapies.
CNN reported that the study analyzed data from Quest Diagnostics, a major commercial laboratory, and examined the outcomes of one million Americans diagnosed with hepatitis C infections in the past decade since the introduction of these highly effective drugs. Overall, only one-third of patients achieved a cure during this period.
Cure rates varied based on age and insurance coverage. Younger patients and those with limited or no insurance were less likely to achieve a cure compared to older patients and those with more comprehensive coverage. Cure rates were as low as 25% for individuals under 40, while 42% of adults over 60 achieved a cure.
The study also revealed that less than 25% of uninsured individuals were classified as cured, compared to 40% of those with commercial insurance and 45% of those on Medicare. The lowest cure rates were observed in uninsured individuals under 40, with only 1 in 6 reaching the target of being cured.
Dr. Frances Collins, a special adviser to President Biden and former director of the National Institutes of Health, expressed deep discouragement at these new statistics, considering that the cure has been available for years. Prompt treatment is not only crucial to prevent liver damage but also to prevent further transmission of the infection.
Some states, including Washington and Louisiana, have been able to expand access by negotiating with pharmaceutical companies to establish subscription services for these drugs, often referred to as the “Netflix model.” These states calculate the total amount they would have spent on treating hepatitis C patients and offer pharmaceutical companies a lump sum in exchange for covering everyone in need of treatment.
Collins commended the success of this approach and expressed the government’s desire to implement it on a national scale. While the upfront cost would be around $5 to $6 billion, it is estimated to save $13.3 billion in treatment costs within a decade. Achieving this goal nationwide will require political will and support from Congress. Successful initiatives at the state level can serve as a blueprint for broader implementation.