The phrase “one size fits all” may apply to some things; baseball caps, ponchos, and theatre seats come to mind. It does NOT, however, apply to the medical treatment of opioid use disorder and the accompanying disease Hepatitis C, known as HCV.
Among those dealing with opioid addiction, the incidence of Hepatitis C virus infection is skyrocketing. Between 2010 and 2016, the number of HCV cases throughout the country tripled, with a majority of those cases linked to injection-drug use of heroin and other opioids.
Spread via the sharing of needles, Hepatitis C is a viral infection that inflames the liver. Untreated, it can lead to a scarring of the liver, known as cirrhosis, and in severe cases, liver cancer. Often, those infected with HCV are unaware of their condition, due to their substance use, only becoming aware of it in one of two ways;
The HCV infection is discovered through a general physical examination that accompanies enrolling in an opioid treatment program.
More serious health issues, such as the previously mentioned cirrhosis, or cancer, force the individual to seek treatment, where the underlying cause is found to be hepatitis infection.
HCV Treatment Options
For those seeking treatment for addiction in a medication-assisted treatment (MAT) program, medical professionals can also assist with a treatment regimen for the HCV infection utilizing a number of new treatment options. Since Hep C has a total of six variations within its’ viral family, the correct treatment option must be carefully chosen based on medical provider assessments and recommendations. Currently, there are only two medications approved for the treatment of all 6 HEP C genotypes; Mavyret™ and Epclusa®. Regardless of the specific medication used, it is critical for the individual to follow through with the complete treatment cycle, to have the best chance of recovery from the infection.
Current studies underway in New York State, appear to indicate that by making HCV and MAT medications available at the same point of contact, the patient/caregiver relationship can be leveraged to better insure that the patient will seek and receive treatment for their Hep C infection. This can be done via telemedicine, with pretreatment testing done at the addiction treatment location, followed by administration of the appropriate HCV medications and methadone in an observed setting.
Treating HCV in Correctional Facilities
Our nation’s correctional facilities also face the challenge of how best to deliver Hep C Treatment. One out of every 7 inmates is infected with chronic hepatitis. Out of the approximately 9 million persons spending time in jail or prison, more than 1.2 million will have an HCV infection. As corrections professionals struggle to meet the financial burden of treatment for these individuals. With a typical 8-12 week treatment regimen, even the discounted price of $25,000 per inmate, would break the budget of even the best funded corrections system. One unique proposal, offered up by professionals from Brown University, the Alaska Department of Corrections, and the law firm of Powers, Pyle, Sutter, and Verville, suggests that drug manufacturers offer “nominal pricing” to corrections facilities, treating them as “safety-net facilities”. This pricing, deeply discounted, yet well above the manufacturing cost, would provide a variety of benefits;
Enable corrections facilities to more economically address Hepatitis infections among the inmate population, ultimately reducing the cost of care brought on by the lack of early intervention.
Provide the drug manufacturers with an additional revenue point, with the reduction in profit margins being offset by increased volume.
Inmates released from incarceration would be returned into society healthier, with fewer long-term health issues, resulting in a reduced impact to the Medicaid system.
As long as the public struggles with opioid addiction and related issues, such as Hepatitis C infection, treatment providers will continue to look for new and innovative methods of care to further insure better and more positive outcomes for their patients. For more information or to begin treatment, contact us today.