Lorne Cross MD, Medical Director, on Oregon's Effort to End Hep C

Oregon has the highest hepatitis C mortality rate in the United States, with 500 people dying each year from the disease, and the third highest rate of infection. Because of this, the state is making drastic changes in hopes of eradicating the virus. The Oregon Health Authority is now working to expand hepatitis C treatment to everyone infected on the Oregon Health Plan.

Hepatitis C is a viral infection spread through contact with infected blood. The virus causes liver inflammation and which can sometimes lead to severe liver damage. Many people with the disease show no symptoms until the virus damages the liver to the point you start displaying signs and symptoms of liver disease. Symptoms include fatigue, jaundice, swelling in the legs and weight loss, among others. In the early stage, hepatitis C can be treated, and sometimes cured, with antiviral drugs.

In November, the state advisory committee on drugs and treatments recommended expanding hepatitis C treatment. Previously, the cost of Sovaldi, a breakthrough drug introduced in 2014 cost $1,000 for one pill, which came out to $84,000 for a week of treatment. With cheaper competitors now on the market, the company has stated they will market hepatitis drugs for a third of the original price.

In 2017, Oregon’s Medicaid system spent $45 million on drugs to treat hepatitis C. These drugs have a 95 percent cure rate, but because of their price, the Oregon Health Authority had rationed their use to only patients with the most need. Only those with a fibrosis score of F3 and F4 were treated with medication.

The state registry lists over 75,000 people as infected with the virus. State officials estimate there are more than 100,000 others also infected and unaware of it. Of the 75,000 infected, an estimated 16,000 to 30,000 are on Medicaid. Under the new recommendation, those individuals will be eligible for treatment. Forty-five percent of those individuals have either F1 or F0 level of liver scarring.

The recommendation also lifts a previous requirement that those suffering from substance abuse problems receive addiction treatment before undergoing treatment for hepatitis C.

While the cost of treating all of these individuals may seem high, in the long run, it’ll save the state money as they won’t have to treat people with serious complications as a result of the virus and it will help prevent the virus from spreading further.

A state analysis has found that treating only 12 percent of the infected population could mean Oregon would eliminate the virus in a decade.

About Lorne Cross, MD

Lorne Cross MD is a healthcare professional who specializes in addiction medicine. He currently serves as the Medical Director Willamette Valley Treatment Center, where he oversees a Medication-Assisted Treatment (MAT) program for those suffering from drug addiction.

Lorne Cross MD also helped to implement a new pilot program at the Yamhill County Correctional Facility that offers MAT to inmates.

This article was originally published on LorneCrossMD.net.