Hepatitis C Treatment Access
Hepatitis C is a viral infection that can cause harm to the liver over many years. There is no vaccine for hepatitis C (HCV), and the virus is typically transmitted via blood transfusions (before 1992) or IV drug use. Treatment for HCV has historically been ineffective, complex, and accompanied by painful side effects. However, in 2014 the FDA approved a new set of medications (DAAs) that offer a highly effective cure (without significant side effects) in approximately 8-12 weeks via a daily pill. While these medications previously cost ~$100,000 per course of treatment, the cost of the drugs have decreased rapidly, now carrying a typical sticker price of just under $20,000. Treating patients living with HCV is of significant public health importance, as patients who are left untreated may develop liver cancer, cirrhosis, and require a liver transplant. Yet due to the perceived high cost, many health care payors (particularly Medicaid) across the country have created barriers to accessing the treatment. For example, in Iowa a patient must document six months of sobriety from alcohol and drugs, as well as stage three or four liver damage (out of four stages), in order to receive the medication. These medications do not reverse liver damage, thus it is important to treat patients for HCV immediately after diagnosis. Furthermore, active drug users are the most likely to transmit the virus.
By treating all people, regardless of sobriety, we can significantly reduce the rate of transmission and of new cases. While some have argued that people who use drugs do not care about their health enough to take a medication as prescribed, multiple studies have documented that people engaged in chaotic substance use are able to complete treatment easily.
HCV is the leading infectious disease killer in the United States, and kills more people each year than the next 60 leading infectious diseases, combined. There are millions of people in the U.S. living with hepatitis C, but without federal action to ensure evidence-based, equitable, and unlimited treatment access, countless lives will be lost and billions of dollars generated in health care cost.
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Iowa Department of Public Health Hepatitis Action Plan, 2017 – 2021
Hepatitis C: The State of Medicaid Access; Center for HIV Law and Policy, Harvard University
A National Strategy for the Elimination of Hepatitis B & C; Institute of Medicine
2019 Viral Hepatitis Progress Report; National Viral Hepatitis Roundtable
Tulsi Gabbard on Hepatitis C Treatment Access
Gabbard has not issued specific statements to this issue.
In 2016, while serving as a House Representative for Hawai’i, Gabbard voted in favor of the Military Construction and Veteran Affairs funding bill for Fiscal Year 2017, which included $850 million for health care needs of veterans, including treatment of hepatitis C.
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Rep. Tulsi Gabbard Votes for VA Funding and $200 million for Hawai’i Military Construction
May 19, 2016 | Tulsi Gabbard House website
Beto O’Rourke on Hepatitis C Treatment Access
While visiting the Iowa Harm Reduction Coalition, O'Rourke expressed support for policies and programs that provide people with access to hepatitis C treatment without requirement for sobriety or advance-stage disease.
O’Rourke did not provide comment on Hepatitis C treatment when asked directly about it by HIV+ Magazine, Sept 9, 2019.
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Beto O’Rourke Explains His Positions on HIV
HIV+ Magazine | September 9 2019 | Jacob Anderson-Minshall
Watch: Beto talks HIV at the Iowa Harm Reduction Coalition
October 24, 2019
Beto’s Plan to Address Substance Use Disorders and the Opioid Epidemic
Medium | October 24, 2019 | Beto O’Rourke
Andrew Yang On Hepatitis C Treatment Access
Yang has not issued specific statements to this issue
Elizabeth Warren on Hepatitis C Treatment Access
Warren supports Medicare for all.
Warren would pressure prescription drug companies to lower medication prices.
Warren would work to ensure comprehensive, inclusive reproductive and sexual health education and services.
Warren pledges to expand HIV research and treatment.
Warren would overturn HIV-status crminalization and discrimination laws and regulations.
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Battle of 1498
Rep. Khana Website, March 15, 2018 | Alexander Zaitchik
2020 Presidential Candidate HIV Questionnaire
AIDS United, 2019
Bernie Sanders on Hepatitis C Treatment Access
Sanders supports Medicare for all.
In 2015, Senator Sanders wrote a letter to the Secretary of Veterans Affairs urging him to use federal law to to break the patents on hepatitis C drugs to authorize third parties to manufacture or import them for government use. This was after the VA stopped enrolling new HCV patients due to lack of funds for the price the medication was being marketed at.
Sanders has discussed using a statute in U.S. patent law, which allows the government to override drug patents and license the production of cheap generics if it serves the public interest, to lower costs of new hepatitis C treatments.
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The Battle of 1498
AlterNet, March 14, 2018 | Alexander Zaitchik
Letter to Secretary Robert A. McDonald
Sanders senate website, May 12, 2015
Amy Klobuchar on Hepatitis C Treatment Access
The Senate Finance Committee released a report in 2015 which revealed that the hepatitis C drug ‘Solvadi’ was being priced and marketed to maximize profits for a pharmaceutical company, and was at the expense of consumers. In response to this report, Klobuchar called on Congress to act immediately to pass legislation to lower prescription drug prices for consumers.
“It is as clear as ever: we have an urgent problem with the cost of prescription drugs in our country. This report presents yet another example in which a drug manufacturer’s first priority is how much money it can squeeze from consumers with no regard for what it means for the Americans who need its treatment. This is an alarming trend that we cannot allow to continue. We need to pass legislation to protect consumers from the unjustified inflation of prescription drug prices.”
In Light of New Report on Profit-Driven Prescription Drug Pricing, Klobuchar Continues Call for Congress to Immediately Pass Her Legislation to Lower Drug Prices for Consumers
Amy Klobuchar senate website, December 1, 2015
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In Light of New Report on Profit-Driven Prescription Drug Pricing, Klobuchar Continues Call for Congress to Immediately Pass Her Legislation to Lower Drug Prices for Consumers
Amy Klobuchar senate website, December 1, 2015
Kamala Harris on Hepatitis C Treatment Access
Harris has not issued specific statements to this issue.
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Kamala Harris releases ‘Medicare for all’ plan with a role for private insurers
NPR, July 19, 2019 | Danielle Kurtzleben
Julián Castro on Hepatitis C Treatment Access
Castro has not issued specific statements to this issue.
Pete Buttigieg on Hepatitis C Treatment Access
Buttegieg has not issued specific statements on this issue beyond the quoted comments from the 2019 AIDS United questionnaire, which support ensuring hepatitis C treatment through broader adoption of Medicaid expansion.
“Access to comprehensive health care services that includes … treatment for hepatitis C by assuring broader adoption of Medicaid expansion and through existing networks of safety-net providers.”
2020 Presidential Candidate Questionnaire
AIDS United, 2019 | Pete Buttigieg
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2020 Presidential Candidate Questionnaire
AIDS United, 2019 | Pete Buttigieg
Cory Booker on Hepatitis C Treatment Access
Booker has not issued specific statements to this issue.