Treatment Update: Veterans With Hepatitis C

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Treatment Update: Veterans With Hepatitis C

Veterans Administration broadens access to hepatitis C treatment

Recently, there’s been lots of talk about new treatments for hepatitis C. Though medicines approved by the Food and Drug Administration in late 2013 have a very high cure rate and fewer serious side effects than older treatments for the virus, “hepatitis C continues to be a crisis in African-American and other minority communities,” said Charles Howell, M.D., chief of medicine at Howard University Hospital, during the National Medical Association’s Colliquium in National Harbor, Maryland, earlier this month. (The conference brought together prominent medical experts to address various health issues plaguing the African-American community, including hepatitis C, sickle cell disease and diversity in medical education.)

It’s a crisis, Dr. Howell said, with an increasing bill, running about $2 billion in health-care costs in 2003 and expected to top $6 billion from 2010-2019.
It’s also a crisis among military veterans. In fact, one in 10 U.S. veterans has hepatitis C (an estimated 180,000 people), a rate five times greater than that of the general population. And one in five of veterans infected with hepatitis C are from the Vietnam era. Despite the availability of highly effective direct acting antiviral regimens since 2014, and though the Department of Veterans Affairs (VA) has long led the country in screening for and treating hepatitis C, the department estimates that only about one in five veterans has been treated with the newest medications.

That’s about to change. The VA announced earlier this month that it can now fund care for all veterans with hepatitis C for fiscal year 2016 regardless of the stage of their liver disease. The VA has received funding from Congress and lowered pricing from some pharmaceutical companies to support this more aggressive treatment.

“As the single largest provider of chronic hepatitis C care in the United States, our goal has been to treat every veteran with HCV infection,” said Sloan Gibson, deputy secretary for the Department of Veterans Affairs.

In 2015, VA allocated $696 million for new hepatitis C drugs, about 17 percent of the VA’s total pharmacy budget. Officials anticipate spending nearly $1 billion on hepatitis C drugs this year.

“We’re honored to be able to expand treatment for veterans who are afflicted with hepatitis C,” said David Shulkin, M.D., VA under secretary for health, in a statement. “To manage limited resources previously, we established treatment priority for the sickest patients. Additionally, if veterans are currently waiting on an appointment for community care through the Choice Program, they can now turn to their local VA facility for this treatment or can elect to continue to receive treatment through the Choice Program.”

Roslyn Daniels