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Treat Hep C In Prisons? Could Cost $76B, But Break Epidemic

CDC Hepatitis C awareness campaign poster

CDC Hepatitis C awareness campaign poster

By Richard Knox

The hepatitis-C epidemic – five times bigger than the HIV epidemic – is finally getting the attention it needs, thanks to the sudden availability of costly new treatments that can cure almost everyone with this potentially deadly liver infection.

But there’s one big piece of the problem that almost no one talks about: the concentration of hep-C infections in the nation’s prisons and jails.

One out of six inmates has hepatitis-C, compared to something like one in 100 in the general population. Since the U.S. incarceration rate has soared in recent years, that means around 400,000 out of the 2.3 million American inmates are infected.

The reason is that most (but by no means all) hep-C infections result from contaminated needles and street drug use.

The hep-C epidemic is a catastrophic cost burden for the nation’s federal, state and local prisons. But it also represents a precious opportunity to get a jump on ending this insidious epidemic — the leading cause of liver failure, liver transplantation and liver cancer. So, who should pay, and how much?

First, the economic downside.

If all 17 percent of infected inmates were to get treatment – which could clear the nasty virus in almost all of them – it would cost at least $33 billion for the medication alone, according to the authors of an analysis in this week’s New England Journal of Medicine.

But that’s not the whole story. A lot more people cycle through US correctional facilities and jails every year; that number is something like 10 million. If only half of those got the new virus-clearing medications, the analysis says, it would cost about $76 billion.

What do those big numbers mean? Continue reading