New Hepatitis C Drugs Are Very Costly And Unavailable To Many State Prisoners
New Hepatitis C Drugs Are Very Costly And Unavailable To Many State Prisoners
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DOI：
10.1377/hlthaff.2016.0296
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发表时间：
2016-10-01
期刊：
影响因子：
9.7
通讯作者：
Gonsalves, Gregg S.
中科院分区：
文献类型：
--
作者：
Beckman, Adam L.;Bilinski, Alyssa;Gonsalves, Gregg S.
在美国，囚犯承担着丙型肝炎疫情的大部分负担。然而，人们对州立监狱治疗丙型肝炎的范围和成本知之甚少--特别是在直接作用抗病毒药物发布后。在惩教部门报告数据的41个州中，106,266名囚犯(占囚犯总数的10%)在2015年1月1日左右被发现患有丙型肝炎。这些囚犯中只有949人(0.89%)正在接受治疗。截至2015年9月30日，为期12周的直接作用抗病毒药物，如索布韦和联合用药利地帕韦/索布韦的价格差异很大(分别为43,418美元至84,000美元和44,421美元至94,500美元)。与其他政府机构相比，许多惩戒部门获得的折扣较小。为了减少丙型肝炎的流行，州政府应该增加对受感染囚犯的治疗资金。州惩戒部门应该考虑与其他政府机构合作，与制药公司和合格的医疗机构谈判折扣事宜，以便通过联邦340B药品折扣计划提供药物。帮助囚犯在获释后过渡到社区的提供者，可以加强在监狱中治疗丙型肝炎所取得的成果。
Prisoners bear much of the burden of the hepatitis C epidemic in the United States. Yet little is known about the scope and cost of treating hepatitis C in state prisons-particularly since the release of direct-acting antiviral medications. In the forty-one states whose departments of corrections reported data, 106,266 inmates (10 percent of their prisoners) were known to have hepatitis C on or about January 1, 2015. Only 949 (0.89 percent) of those inmates were being treated. Prices for a twelve-week course of direct-acting antivirals such as sofosbuvir and the combination drug ledipasvir/sofosbuvir varied widely as of September 30, 2015 ($43,418-$84,000 and $44,421-$94,500, respectively). Numerous corrections departments received smaller discounts than other government agencies did. To reduce the hepatitis C epidemic, state governments should increase funding for treating infected inmates. State departments of corrections should consider collaborating with other government agencies to negotiate discounts with pharmaceutical companies and with qualified health care facilities to provide medications through the federal 340B Drug Discount Program. Helping inmates transition to providers in the community upon release can enhance the gains achieved by treating hepatitis C in prison.