In a recent perspective published by the New England Journal of Medicine (NEJM), Stanford Law student Alexandra Daniels analyzed a growing body of federal litigation brought by prisoners with the hepatitis C virus (HCV) who are seeking access to treatment for their condition. With co-author and mentor, Law Professor David Studdert — also a professor of medicine at Stanford Health Policy — Daniels documented the dire public health problem of HCV in prisons.
“People incarcerated in prisons account for approximately one third of HCV cases in the United States” the authors wrote, and nearly one in five prisoners are infected, compared with 1 percent of the general population.
HCV is a slow-moving disease, but left untreated it eventually leads to cirrhosis, cancer, liver failure, and death.
A new wave of “miracle” drugs for treating HCV appeared in 2014. Direct-acting antivirals–or DAAs–are far more effective than anything previously known. The catch–they are extremely expensive, upwards of $50,000 for a course of treatment. This creates a far higher price tag for universal treatment than most prison systems can afford. The result is that, even though prisons are the epicenter of the HCV epidemic, only a small minority of prisoners have gained access to DAAs.