Hepatitis C Can Be Eliminated in U.S., Says National Academy

Between 3 and 5 million people are estimated to have hepatitis C (HCV) in the United States. Chronic HCV can lead to end stage liver disease and liver cancer, which has increased 56 percent since 2003.�But a new report shows that elimination of HCV in the U.S. is possible.

"We applaud the National Academy of Sciences for releasing its report, "Eliminating the Public Health Problem of Hepatitis B and C in the United States, which concludes elimination of hepatitis C as a public health problem in the United States is feasible and can be achieved with the right resources, commitment, and strategy," said Carl Schmid, Deputy Executive Director of The AIDS Institute.�

According to the Committee on the National Strategy for Elimination of Hepatitis B and C, who authored the report, elimination of HCV is made more difficult since there is no vaccine and efforts, therefore, should be focused on reducing both the risk of transmission and opportunities for infection. But the expert Committee identified several barriers including underfunding of a hepatitis surveillance system in the US, and the fact that only half of chronically infected people with hepatitis C have been diagnosed.

Congress can immediately address this funding shortfall for a surveillance system and increase testing and education by increasing funding this year for the CDC Division of Viral Hepatitis, which is currently funded at only $34 million for the entire country.�The AIDS Institute and others are asking Congress to increase funding to at least $62.8 million in FY2017.

One way to reduce potential transmission, according to the Report, is to cure those who are already infected through the new generation of medications. However, the Committee concluded that while these medications are cost effective, many state Medicaid programs and insurance companies are restricting access to them.

The Centers for Medicaid Services (CMS) last fall sent a letter to all State Medicaid programs telling them that clinical guidelines for the medications should be followed, and restricting access to the medications for only the sickest of patients violates the Medicaid law.

CMS needs to take steps to compel the states to comply with its letter. Insurance plans must also comply with Affordable Care Act regulations and offer the hepatitis C medications in accordance with clinical guidelines without excessive patient cost-sharing and restrictions. The Department of Health and Human Services needs to enforce these provisions, along with others, including ACA nondiscrimination provisions.

The Report also concluded that eliminating hepatitis B, for which there is a vaccine, is feasible in the US.

"We appreciate the Committee's report and their conclusion that hepatitis C can be controlled, and eventually eliminated. As the Committee wrote, we have the tools, but now just need the resources to address the many barriers identified in the report. We look forward to working with the Committee as it begins Phase 2 of its work, which is to identify a strategy to eliminate hepatitis C and recommend a course of action," concluded Schmid.