Hepatitis C treatment example of innovation, market competition — and unfinished business

Congress should continue to make treatment affordability a pillar for patients, but it can’t come at the cost of ignoring significant progress for life-threatening illnesses like hepatitis C (HCV). Due to innovation, we can cure HCV today. New treatments for HCV represent a revolution in medicine — the first ever cure for a chronic viral infection; yet treatment rates are declining, and barriers to effective care are deepening inequities for those with or at risk of contracting the virus. To fully leverage these cures and end this virus, lawmakers in Washington, D.C., should focus on policies that will improve funding for programs that increase access to testing and effective treatment for hepatitis C — and eliminate healthcare inequalities in the process. 

Hepatitis C virus is a devastating infection transmitted through blood or bodily fluids, which often causes liver disease. Left untreated, HCV can cause liver scarring, cirrhosis, and liver cancer. The unfortunate reality is that HCV can go undiagnosed for years because many people with the disease don’t exhibit symptoms.

Early in the fight against HCV in the 1990s and 2000s, people living with the virus relied on interferon injections and ribavirin pills, treatments that caused side effects and were often unsuccessful in ultimately curing people of the virus.

Over decades, those challenges for patients have been addressed through groundbreaking innovations that have drawn us closer to the possibility of ending the HCV epidemic. That innovation resulted in FDA approval of first-generation direct-acting antivirals (DAAs) in 2011. At the time, this medical breakthrough represented a massive step forward in treating and, in many cases, curing HCV. I was cured with one of those breakthrough drugs in a clinical trial in 2009. In 2013, second-generation DAAs were discovered, leading to treatments with a 95 percent cure rate today.

DAAs illustrate how continued innovations can change the trajectory of disease and demonstrate how forces outside of the policymaking process — for instance, market competition and continued research — can make these treatments more affordable.

Recent research shows that DAAs for HCV are more affordable and cost-effective due to the continued development and availability of improved HCV treatments. It’s projected that our medical system will save an estimated $49 billion on HCV treatment costs over the next decade as a result. That translates into savings of more than $57,400 per individual treated for HCV.

A disease that was once considered a death sentence is now curable, and a treatment once characterized as too expensive is now more broadly accessible, particularly among vulnerable communities.

But despite the progress made in developing safe, affordable, and effective treatments, several remaining barriers are prolonging the HCV epidemic. Today, the opioid epidemic continues to generate spikes in injection drug use, there remains a lack of diagnostics due to insufficient government funding, and we have no requirements for universal HCV testing.

President Biden pledged to eliminate viral hepatitis by 2030, an ambitious goal matching a similar declaration by the World Health Organization (WHO). Unfortunately, current projections show that because of the aforementioned barriers, over 500,000 Americans will likely still be living with the virus in 2030.

Achieving the president’s goal begins with removing policy restrictions that prevent people from accessing hepatitis C treatments in state Medicaid programs, implementing and financing proven care coordination and patient navigation models, and requiring universal HCV screening along with the funding to do so. It’s a path that will help us end the epidemic — and close disparities in care for communities of color disproportionately impacted by the disease.

The story of HCV should give us hope of what is possible when we drive innovations for hard-to-treat diseases. It is also a story only half-written, as roughly 2.4 million Americans currently live with the illness. To fully leverage medical innovation and end this virus, we must redouble our efforts and ensure that everyone has access to screening and treatment for HCV through appropriate funding and regulation from the federal government.

Michael Ninburg is the executive director of the Hepatitis Education Project (HEP).