Tennessee Prison Officials Request Millions to Fight Hepatitis C

In Tennessee, the battle for Hepatitis C (HCV) treatment access in prisons continues to intensify. In light of a steady stream of studies about the disease’s untreated prevalence in prison facilities, and a summer in which two inmates sued the state for access to treatment, Department of Corrections officials in Tennessee have requested the Governor more than double funding for the disease’s care.

The state’s Department of Corrections Commissioner Tony Parker this month asked for a $4 million budget for HCV treatment in 2017, up from $1.6 million this year and $1.1 million in 2015.

The Tennessean, which has closely followed the story, reported in May that out of nearly 3,500 people incarcerated the state who were known to have the disease, less than 10 were receiving treatment. HCV rates in the Volunteer State’s prisons have risen dramatically and continually, with known diagnoses in almost a fifth of all inmates and likely many more cases undiagnosed.

Nationwide, it is estimated that as many as 17% of all prisoners carry the disease, which can severely damage the liver and lead to death. Less than 1% of those prisoners are believed to be receiving treatment.

Hepatitis C is curable, thanks to direct-acting antiviral (DAA) drugs, but those can be prohibitively expensive. DAA treatment can cost tens of thousands of dollars, though they can cure 90% or more of HCV cases with a full 12-week treatment course. The disease remains prevalent in society due in part to populations of prisoners and intravenous drug users that lack insurance or access to the necessary drugs.

Tennessee officials have argued that it would cost the Department of Corrections its entire billion-dollar budget to cure its prisoners of the disease at market value, though experts have argued that states could and should leverage the volume of their orders to negotiate lower purchase prices for the drugs. Though Federal prison and health programs have done so successfully, it may be more difficult for state prison systems to do so if forced to act independently.

The class-action lawsuit filed this past summer in Nashville by the American Civil Liberties Union on behalf of two Tennessee inmates asserts that access to healthcare is a fundamental human right, and denying potentially life-saving treatments due to cost may constitute “cruel and unusual punishment.” The trial isn’t set to begin until 2018, though its looming presence may be spurring the recent calls to address the disease among the state’s incarcerated population.

Responding to the Tennessean’s reports in May, the Department of Corrections’ Chief Financial Officer cited blood tests that monitor disease progression as falling under the umbrella of “treatment,” and voiced concerns that “risky behavior” could cause inmates to become reinfected even if cured.

In a report released earlier this year, the International Network for Hepatitis C in Substance Users (INHSU) pointed out “economic and pseudo-scientific barriers,” standing in the way of the disease’s eradication from developed societies.

Related Coverage:

Hep C Treatment: Why Aren't State Prisoners Getting It

Prisons: The Problem and Solution of Hepatitis C?

Prison Study to Focus on Substance Use and Hepatitis C Treatments