In the decade since pharmaceutical maker Gilead launched a breakthrough treatment for hepatitis C, a wave of new therapies have been used to cure millions of people around the world of the blood-borne virus.
Today, 15 countries, including Egypt, Canada and Australia, are on track to eliminate hepatitis C within this decade, according to the nonprofit Center for Disease Analysis Foundation. Each led a fierce national testing and treatment campaign.
But the drug arsenal, which has generated tens of billions of dollars for pharmaceutical companies, has not brought the United States any closer to eradicating the disease.
Spread through the blood, including through intravenous drug use, hepatitis C causes inflammation of the liver, although people may have no symptoms for years. Only a fraction of Americans carrying the virus are aware of the infection, although many develop the deadly disease.
A drug treatment lasting eight to 12 weeks is simple. But those most at risk, particularly those who are incarcerated, uninsured or homeless, have difficulty navigating the American health care system to seek treatment.
Among people diagnosed in the United States since 2013, only 34% have been cured, according to one study. recent analysis by the Centers for Disease Control and Prevention.
“We’re not making any progress,” said Dr. Carolyn Wester, who heads the agency’s viral hepatitis division. “We have models of care that work, but it’s a patchwork. »
Dr. Francis Collins, who led the National Institutes of Health for decades until his retirement in 2021, led a White House initiative to eliminate the disease.
In an interview, he said he was motivated by memories of his brother-in-law, Rick Boterf, who died of hepatitis C just before the new cures were introduced. An outdoorsman, Mr. Boterf endured five years of liver failure while waiting for a transplant, and even that procedure was not enough to save him from the destructive virus.
“The more I looked at it, the more impossible it seemed to get out of it,” Dr. Collins said.
The initiative, which was included in President Biden’s agenda latest budget proposal, is asking for about $5 billion to establish a five-year “subscription” contract. The federal government would pay a lump sum and, in exchange, receive medication for each patient enrolled in treatment.
Several states already use similar subscription contracts, with limited success. Louisiana was the first to deploy such a program, in 2019, and reported a significant increase among people treated by Medicaid and in correctional facilities. But the number of treatments in the state declined during the pandemic and has not rebounded. Today, as it nears the end of its five-year contract, Louisiana has treated barely half of the people it set out to treat.
Dr. Collins acknowledged that a national drug purchasing agreement like Louisiana’s alone would not be enough to reverse the trend.
“Anyone who tries to say, ‘Oh, that’s just the cost of…
