States face costly conundrum: How to treat inmates with hepatitis C

Civil liberties groups in Missouri and at least seven other states are suing to get more prison inmates treated with a new generation of hepatitis C drugs called direct-acting antivirals, which are highly effective but expensive.

Civil liberties groups in Missouri and at least seven other states are suing to get more prison inmates treated with a new generation of hepatitis C drugs called direct-acting antivirals, which are highly effective but expensive. In 2016, only 14 of about 5,000 inmates with hepatitis C in Missouri's prisons received the drugs, according to internal state data obtained by the Roderick & Solange MacArthur Justice Center in St. Louis. The American Civil Liberties Union and MacArthur Justice Center filed a lawsuit in December 2016 to force the Missouri Department of Corrections to provide direct-acting antiviral drugs to inmates with hepatitis C who qualify for treatment. However, if states are required to offer the new drugs, they would run out of money to treat every other medical condition, said Gregg Gonsalves of the Yale School of Public Health. Gonsalves said newer, cheaper drugs could help, and some state prison systems have negotiated discounts. Even at a lower cost, providing these drugs on a large scale could cost states a fortune, but advocates argue it is worth it to stop the disease from spreading.