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Hepatitis C in the U.S. Prison System

Approximately 17% of prison inmates in the United States are living with hepatitis C. A recent study, primarily funded by the National Institutes of Health, showed hepatitis C screening and treatment in state and federal prisons would save an estimated $750 million over 30 years and could diagnose 41,900 to 122,700 inmates infected with hepatitis C.1-4

Researchers found the advantages of screening and treatment in prisons would not only benefit inmates but also the population at large. Screening and treatment in the U.S. prison system would likely prevent 5,500 to 12,700 additional infections after the release of inmates.1 Overall, screening and treatment could prevent as many 11,700 liver related deaths, as many 8,600 liver cancer cases, as many 7,300 related liver failure cases, and as many 900 liver transplants.4

“That’s the whole motivation of this paper, showing if we start treating people in prison, the whole society benefits,” said the senior author of the study, Jagpreet Chhatwal, an assistant professor of radiology at Harvard Medical School.3 “We have to invest money either now or we invest later,” said Chhatwal.2

Treatment is expensive and the newer treatments can cost upwards of $90,000. However, these Direct Acting Antivirals (DAAs) have a sustained virologic rate (SVR) of 90% in 12 weeks of treatment. While up front the costs could be expensive at about $1.15 million and require state correction centers to increase their healthcare budges by 12.4 percent, it would prove to be cost-effective over time. The study proposes an ‘opt out’ method to testing inmates where all inmates would be screened unless they declined. In Massachusetts and Minnesota, several prison inmates have filed class-action suits to gain access to treatment. 3

Overall, researchers found that investing funds into the United States prison system would be a “strategic approach to address the current epidemic.” 1

  1. He T, Li K, Roberts MS, Spaulding AC, Ayer T, John J. Grefenstette JJ, Chhatwal J. Prevention of Hepatitis C by Screening and Treatment in U.S. Prisons. Ann Intern Med. doi:10.7326/M15-0617. Published: November 24, 2015
  2. Kodjak, A. Treating Prisoners With Hepatitis C May Be Worth The Hefty Price. National Public Radio. Published November 23, 2015.
  3. Schwartzapfel, B. The $33 Test in Prison That Could Save Countless Lives on the Outside. The Marshall Project. Published November 24, 2015.
  4. Dallas, ME. Screening Inmates for Hepatitis C Benefits General Community: Study.HealthDay. Published Nov. 23, 2015.