Opinion about the paper-hepatitis cure for r i inmate


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The Rhode Island Department of Corrections has started paying for the treatment of a prison inmate with hepatitis C that relies on a breakthrough new drug that can cure the disease in months but comes with an astronomical cost of $1,000 a day.

The federal Food and Drug Administration approved the use of Sovaldi to cure the liver-destroying disease in December. But a single 12-week course of the much-heralded pill can cost $85,000.

Still, Rhode Island prison officials plan to begin treating three more inmates starting July 1 for an additional estimated cost of $225,000 and have informed the governor and lawmakers that they will need a supplemental budget appropriation for a still unknown total amount.

The drug's approval and its implementation "has all happened so rapidly," said Corrections Director A.T. Wall. The cost "is a source of concern for us. But we have a constitutional obligation to provide the same level of health care to incarcerated offenders as someone would receive in the community."

"We don't feel there is an option not to treat," Wall said. "It would result surely in litigation and so we are prioritizing [which inmates will receive the drug] using the best information we have."

Of the ACI's roughly 3,130 inmates, 177, or 5.6 percent, recently tested positive for hepatitis C, which is usually transmitted through intravenous drug use. The percentage of the infected prison population is probably higher because testing is voluntary.

A recent national study estimated that 1.8 million inmates around the country have the disease, representing almost one-third of all hepatitis cases in the nation.

Wall said the department formed a committee of doctors and prison staff to review individual inmate cases and determine which ones are most advanced and in need of the drug.Wall said he didn't yet know how many inmates may end up having the treatment by year's end or how much it might ultimately cost.

"We have been told there may be new drugs coming on the market this fall that could be less expensive" and equally affective.Under an older protocol of care, inmates were treated with different drugs for as long as a year. The treatment often produced serious side effects and only killed the virus half the time.

Wall said prison officials are also treating a transferred inmate from Connecticut but in that case Connecticut has agreed to pay the associated costs.

Karen Martucci, a spokeswoman for the Connecticut Department of Corrections said her state does not routinely dispense Sovaldi to inmates."However, if an offender enters our system already on a regimen of that particular medication we would continue as such."

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