By Maria Clark, Lafayette Daily Advertiser
Bart Bryant, the clinic coordinator for AcadianaCares, has a waiting list of about 100 patients who have been diagnosed with the viral infection hepatitis C and haven’t been able to afford treatment.
Typically, insurance companies will only cover patients who are at the final stage of the illness, at which point the virus has already caused extensive damage to the liver, he explained. Hepatitis C is spread through contaminated blood and over decades can result in liver failure, liver cancer or cirrhosis if left untreated.
Last year, only 1,100 of the estimated 39,000 people infected with hepatitis C in Louisiana’s Medicaid program were treated due to the high cost of the medication, according to the Louisiana Department of Health. But starting July 15, treatment will become more accessible to the state’s Medicaid population and its prisoners. Health officials said they expect to treat 31,000 hepatitis C patients by 2024.
“This is going to be a game changer for so many people,” said Claude Martin, the CEO of AcadianaCares, an organization that provides an array of services including primary care and substance abuse treatment.
The Louisiana Department of Health finalized an agreement in late June with Asegua Therapeutics, a subsidiary of the drug manufacturer Gilead Sciences, to provide an unlimited supply of the generic antiviral drug Epclusa over the next five years for Medicaid patients and state prisoners diagnosed with hepatitis C. The state will contribute up to $60 million annually to cover unlimited access to the medication, which has a 98 percent cure rate, health officials said.
Until 2011, hepatitis C treatment required weekly injections and oral medication. Some patients experienced severe side effects and others didn’t respond to the medication.
“It was torture for a lot of patients,” Martin said.
The oral medication that is now available has little to no side effects and can clear up the infection in two to six months.
However, without insurance, a course of treatment of Epclusa could cost anywhere between $40,000 to $50,000, according to Dr. Nicholas Van Sickels, who has a medical practice in Alexandria and is the chief medical officer of the CrescentCare clinic in New Orleans.
“When it first came out it was nearly double the cost and nobody could get it unless you had really good insurance,” he said. “We could talk to our patients about it, but the messaging was, ‘You should stay in care, but we can’t treat you.’”
Treatment for hepatitis C was mainly available to HIV patients or patients in the final stage of liver disease. Conditions such as severe fibrosis, a stiffening of the liver, was also given priority for treatment. To receive coverage, patients would undergo an extensive array of testing to check for liver function.
“If you didn’t have severe fibrosis, you weren’t getting treated if you were on Medicaid or in jail,” Van Sickels said. “Now, theoretically, I can treat everyone at my clinic by mid-July.”
Sickels said they are in the process of identifying patients who have tested positive for the virus but have not had consistent medical treatment. They are also testing patients at risk for HIV and hepatitis C and getting them into harm-reduction services.
Symptoms of the disease can take decades to develop, so the U.S. Centers for the Disease Control and Prevention recommends that people who are considered “at-risk” get tested, including those who are currently or have ever injected drugs, people who received blood transfusion or organ transplants, or those who have been exposed to hepatitis C-positive blood.
“We have a good number of people waiting, but there are so many out there who we need to identify and treat over the next five years,” he said.
Access to Epclusa will be life-altering for people like Nicole McArthur, 28, a mother of two who contracted the virus through intravenous drug use when she was around 18 years old. Although McArthur sought out treatment, she was told that because she wasn’t at stage four of the disease she couldn’t qualify for medication.
“If you’re at stage four, you’re dying. That wasn’t hopeful,” McArthur said to a crowded room of people in the CrescentCare clinic in New Orleans when the agreement with Asegua Therapeutics was announced on June 26. “Now I’m hopeful that I can live the rest of my life knowing that I will be free of this deadly disease.”