In a recent report published by the Centers for Disease Control and Prevention (CDC), it was revealed that the majority of people in the United States who have tested positive for hepatitis C have not been cured. This is primarily due to the high cost of oral antiviral treatments and the obstacles imposed by insurance plans. Hepatitis C is often referred to as the "silent killer" because it initially presents with few to no symptoms. However, over time, it can cause serious liver damage and even death.
Breakthrough oral antiviral treatments, such as those made by Gilead Sciences and Abbvie, have been available in the U.S. for nearly a decade. These medications have proven to be highly effective, curing over 95% of hepatitis C cases. Despite their availability, only one-third of the 1 million adults who tested positive for hepatitis C between 2013 and 2022 have been cured. Health officials estimate that there may be another million people in the U.S. who are infected but unaware of their condition.
In 2020 alone, hepatitis C contributed to the deaths of nearly 15,000 people in the U.S. Dr. Jonathan Mermin, director of the CDC division specializing in HIV and viral hepatitis, expressed concern over the preventable deaths caused by a curable infection.
In response to this public health crisis, the Biden administration has requested $11 billion in funding from Congress to establish a national program aimed at eliminating hepatitis C by 2030. Dr. Francis Collins, who is leading the initiative at the White House, believes that this program will save thousands of lives and reduce healthcare costs in the long run.
The primary obstacles to treatment are the requirements imposed by health insurance plans and the high cost of treatment. The cost of the oral antiviral pills can reach up to $24,000 per patient. Some health insurers require burdensome preauthorization and limit the healthcare providers who can prescribe the medications. Even state Medicaid plans have imposed requirements such as evidence of liver disease and sobriety, making it difficult for everyone who is infected to receive treatment.
Under Biden's proposal, the federal government would pay pharmaceutical companies a lump sum for the drugs, which would then be made available for free to the uninsured, state Medicaid programs, prison systems, and people living on Native American reservations. This approach is based on a successful model implemented by Louisiana in 2019.
In addition to addressing the cost and access barriers, efforts are also being made to improve diagnosis and treatment. The National Institutes of Health (NIH) and the Food and Drug Administration (FDA) are working on the approval of a rapid hepatitis C test that would provide a diagnosis in an hour or less. This would enable patients to receive a diagnosis and begin treatment in a single visit, improving overall outcomes.
Overall, the issue of hepatitis C treatment in the U.S. highlights the need for affordable and accessible healthcare for all. The high cost of treatment and the barriers imposed by insurance plans have prevented many from receiving life-saving care. The proposed national program and ongoing efforts to improve diagnosis and treatment are steps in the right direction to address this public health concern.