Giving pricey hepatitis drug to prisoners may be financially wise

Giving pricey hepatitis drug to prisoners may be financially wise

(Reuters Health) – When prisoners have hepatitis C, treating them with expensive new antiviral drugs makes fiscal sense despite the hefty price tag, according to a new study.

Based on computer models, new pricey drug combinations that treat hepatitis C infections were more cost-effective than older drug combinations and no treatment at all, researchers found.

“Essentially what our model does is follow a hypothetical cohort of prisoners that looks like a prison population in the U.S.,” Jeremy Goldhaber-Fiebert told Reuters Health.

“It allows us to ask a variety of ‘what-if’ questions and probe how sensitive our findings are to various factors,” said Goldhaber-Fiebert, the study’s senior author from Stanford University in California.

Hepatitis C is a viral infection of the liver that is typically transmitted when the blood of an infected person enters the body of a healthy person. (Most commonly, this happens when people share needles, syringes, or other equipment to inject drugs – but before 1992 hepatitis C was also transmitted by blood transfusions.)

When people are first infected, the symptoms can include fever, nausea, stomach and joint pain, dark urine, vomiting and a yellowing of the skin and eyes.

If left untreated, hepatitis C can slowly, over years or decades, lead to liver damage, liver failure, liver cancer, and a need for liver transplant, according to the Centers for Disease Control and Prevention (CDC). It may also lead to death.

The CDC says about 3.2 million people in the U.S. are infected with the chronic disease. Goldhaber-Fiebert and his colleagues write in Annals of Internal Medicine that about 500,000 incarcerated people have hepatitis C.

Until recently, the virus was treated with a combination of drugs that had to be taken for about a year and caused people to have flu-like symptoms. The treatment was only effective in a minority of patients.

The U.S. Food and Drug Administration (FDA) approved Merck’s Victrelis, which is known generically as boceprevir, in 2011 to be added to the existing combination of drugs. The new combination made the treatment more effective – and more expensive (see Reuters story of May 13, 2011 here: reut.rs/1yg9GGm).

Then, the FDA approved Gilead’s Sovaldi,
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