posted on thu, jul. 24, 2003
prisons to reduce hepatitis treatment
fewer pa. inmates will be eligible, due to budget issues. officials say the candidates will be better targeted.
by mark fazlollah
inquirer staff writer
http://www.philly.com/mld/inquirer/6369952.htm
faced with looming state budget problems, pennsylvania prisons this fall will begin reducing by about 75 percent the number of inmates being treated for the potentially deadly hepatitis c virus.
pennsylvania now has 8,030 state inmates infected with hepatitis c and is treating 550, said fred maue, chief of medical services for the department of corrections. he said those 550 would get their medicines, which cost $16,000 per patient for a 48-week course of treatment.
but beginning in september, he said, prisons will apply stricter rules for treating infected inmates. he estimated that 130 a year would receive medicines and that that number eventually might be cut to fewer than 100. he said the number of infected inmates is likely to remain constant - about 23 percent of the prison population.
"we were facing medical cutbacks. we were faced with having to live with a limited budget," he said. "we felt that we needed to prioritize our budget."
maue said much of the treatment would be focused on prisoners with a highly curable form of hepatitis c - about 15 percent of those infected.
he stressed that the reduction in treatment was justified because the state was doing better at targeting patients who could benefit from the medicine.
thomas shaw-stiffel, a specialist at pittsburgh's center for liver diseases, said that approach might get more bang for the buck.
"it's to the patients' benefit to be more focused," said shaw-stiffel, who worked with the university of rochester's hospital when it was treating new york inmates with hepatitis c. "on the surface, [the reduction] may look ominous, but it may be beneficial."
the new guidelines are in line with national prison standards.
more than three million americans are infected with hepatitis c, with a huge portion rotating through the correctional system. an estimated one million infected inmates leave jails and prisons each year, the u.s. centers for disease control and prevention says.
nationally, hepatitis c is the leading reason for liver transplants. it has become one of the leading causes of death among pennsylvania inmates.
the reduction in treatment comes at a time when the medications are more successful in effectively curing the disease - prompting some criticism that the state is going in the wrong direction.
"it's disappointing," said lawyer angus love, director of the pennsylvania institutional law project, when told of the state's new rules. "it's not surprising, given the budgetary constraints."
despite the reductions in treatment, pennsylvania will still be providing more care than many states. new jersey, for example, is treating 33 inmates - a dramatic change from last year, when it was treating one. officials do not know how many inmates are infected because new jersey prisons do not conduct widespread testing.
under govs. tom ridge and mark schweiker, pennsylvania developed one of the nation's most aggressive treatment programs. in the past, the state's secretary of corrections had boasted that his department was saving lives of inmates. the secretary, jeffrey a. beard, also said that treating the disease in prisons made inmates less likely to spread it after their release.
maue said his department last year was "over our budget," spending about $8.8 million for treating hepatitis c.
he estimated that for this year, "top dollar would be $6 million," with treatment costs even lower next year.
maue said prisons would require that inmates have at least 18 months remaining on their sentences before consideration for medication. in the past, inmates were required to have a year left on their sentences.
inmates also will be required to undergo liver biopsies before being considered for treatment.
