511 Hepatitis C Treatment (E)

Submitted by:  American Association of Public Health Physicians 

WHEREAS Hepatitis C virus (HCV) infection has a variable course, with progressive and life-threatening disease in about 20% of infected persons and with a non-progressive course in 53-64% of infected persons; and

WHEREAS newer drugs for HCV infection are very effective in clearing infection, when taken correctly, and have generally low toxicity; and

WHEREAS ample data show reduced mortality after Sustained Viral Response (SVR) due to hepatitis C treatment in the era of interferon-based treatment, when treatment was generally given to HCV-infected persons with significant fibrosis; and 

WHEREAS successful treatment of HCV prevents the infection of others with HCV; and

WHEREAS the manufacturers of newer drugs for HCV infection are currently charging astonishingly high prices for each course of treatment; and

WHEREAS successful treatment of HCV does not prevent re-infection in persons who continue (or resume) behaviors that put them at risk for HCV infection; and

WHEREAS it is unclear whether immediate treatment of all HCV-infected persons conveys a net benefit in terms of reduced mortality, compared to treatment deferral; and

WHEREAS society requires all healthcare entities, governmental and private, to be prudent stewards of healthcare resources; and

WHEREAS correctional facilities have a uniquely high concentration of HCV-infected persons, a proven ability to monitor health status and treatment compliance, a constitutional responsibility to provide medically necessary healthcare, and severely constricted budgets; and

WHEREAS physicians in all settings have an ethical obligation to advocate for their patients’ best interests and for sound public health policy; therefore be it

RESOLVED that our AMA supports hepatitis C virus (HCV) prevention, screening, and treatment programs that are targeted toward patients who would benefit the most, and toward maximum public health benefit; and be it further

RESOLVED that AMA supports adequate funding by governments, insurance companies and other third party payers, including negotiation for more reasonable pricing of HCV antivirals, so that all Americans for whom HCV treatment would have a substantial proven benefit will be able to receive this treatment; and be it further

RESOLVED that our AMA recognizes correctional physicians, and physicians in other public health settings, as key stakeholders in the development of HCV treatment guidelines.