Study: Hep C screenings in prisons would benefit more than inmates

A new study concludes that increased screenings for Hepatitis C virus among prisoners might reduce cases of infections nationwide and lower treatment costs inside and outside of prisons.

The Hepatitis C virus (HCV) infects only 1 percent of the U.S. population, but more than 17 percent of prisoners. It is the leading cause of liver cancer among the general community, and a frequent cause of death among inmates.

HCV is most commonly transferred by the use of injected drugs.

Investigators from the Massachusetts General Hospital and the University of Pittsburgh Graduate School of Public Health conducted a study revealing that Hepatitis C screenings for prison inmates would benefit more than just the prison population.

The report, published in the Annals of Public Medicine, explained the development of a computer model in order to project the outcome of screening strategies.

Senior author Jagpreet Chhatwal of the MGH Institute for Technology Assessment said the increase of advanced screenings would lead to reduced cases of liver cancer, liver disease and death.

From the press release:

The four scenarios were one-time screening of current and newly incarcerated individuals with a history of injected drug use or universal opt-out screening of all current inmates as well as new inmates for one, five or ten years. ...

The simulation indicated that the four strategies would diagnose from 42,000 to almost 123,000 new cases of HCV among inmates over a 30-year period.

Treating these individuals when their disease reached an advanced stage could prevent from 5,500 to 12,700 new transmissions over that period; and compared with no screening, prison screening could prevent 4,200 to 11,700 liver-related deaths – 80 percent in the community – 3,000 to 8,600 cases of liver cancer, 2,600 to 7,300 cases of end-stage liver disease, and the need for 300 to 900 liver transplants.

The declining number of cases suggests reduced costs associated with HCV in the future. Several drugs have been made available that have the power to eliminate the disease, but these options are costly.

In May, PublicSource reported that 205,000 Pennsylvanians and 3.2 million in the country suffer from this disease, but the high costs of the all-oral medication are leaving people untreated.  

From the press release:

The simulation indicated that the universal opt-out strategies would cost up to $29,000 for each quality-adjusted life year, well within cost-effectiveness standards. In comparison, screening individuals in the general public for HCV infection based on their year of birth – a recommendation the U.S. Centers for Disease Control and Prevention added to risk-associated screening in 2012 – costs $35,000 to $65,000 for each additional life year, considerably more than opt-out prison.

Intern Christine Manganas can be reached at cmanganas@publicsource.org.