A new study finds that effective new
hepatitis C drugs are so expensive the state of Rhode Island would have
to spend almost twice its entire prison health budget to treat all its
chronically infected inmates. Even providing the medicine only to the
very sickest inmates who will remain in custody for at least another
year would exceed the state prison system's pharmacy budget more than
five times over.
The budget impact analysis, published online in the Journal of Urban Health,
provides detailed new evidence of the "sticker shock" that states face
in battling an epidemic that affects millions of people nationwide. The
prevalence of the liver disease,
which is often spread via injection drug use, is especially high in
prisons. Meanwhile, the U.S. Supreme Court has obliged prison systems to
provide inmates with care comparable to what is available in the community.
"The big problem is, even if you just take the most advanced disease,
you can't afford it with the current correctional budget," said Dr.
Brian Montague, assistant professor medicine and public health at Brown
University and a physician in the Division of Infectious Diseases at The
Miriam Hospital, who led the study. "There was an option to defer
treatment before because the [prior] treatments were significantly more
toxic and the risks often outweighed the benefits. Now, with safe and
highly effective treatments, morally and ethically there's no option to
not treat, particularly for those with more advanced disease."
Labels: costs, Rhode Island, treatment in prisons