More hepatitis C virus (HCV) treatment in correctional facilities, a possibility if medication costs were to drop, is essential to controlling the hepatitis C epidemic in the US, according to researchers from the Rollins School of Public Health and Harvard University.

In a new paper published in the June 2018 edition of the Infectious Disease Clinics of North America, Anne Spaulding, MD, MPH, associate professor in the Department of Epidemiology at Emory University Rollins School of Public Health, along with Jagpreet Chhatwal, PhD, assistant professor at the Harvard Medical School, pose five questions and possible solutions to address dilemmas faced by correctional and public health administrators in the screening and treatment of HCV in correctional facilities.

“Screenings for hepatitis C in the prison system have a high yield, as nearly one-third of infected individuals in the US interact with the criminal justice system each year,” explains lead author Spaulding.

“The new therapies available mean that nearly all persons with the disease, including those incarcerated, can now be cured,” adds co-author Chhatwal. “The issue is that the treatment price is high and the budget for treatment in prisons is limited; as a result, the majority of incarcerated people with hepatitis C cannot access these medications.”

For years, the prevalence of hepatitis C was declining in prisons; however, the current opioid epidemic has reversed that trend. Researchers note that greater access to hepatitis C treatment in the prison setting could help reignite the past decline in the prevalence of HCV. They advocate nominal pricing, where pharmaceutical companies extend a price to prisons that is less than one-tenth of the average manufacturer’s price.

“Nominal pricing will still permit pharmaceutical companies to sell the drug above production price,” says lead author Spaulding. “This pricing strategy will directly address the epidemic and open up access to curative treatment for the most vulnerable patients.”