United States National Hepatitis C Elimination Initiative

US National Hepatitis C Elimination Initiative
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United States National Hepatitis C Elimination Initiative

The US Centers for Disease Control and Prevention (CDC) estimates that more than 2 million people in the US are living with hepatitis C. This burden is expected to grow, and despite the availability of effective antiviral therapies, a recent CDC report revealed that only 1 in 3 US adults who had been diagnosed with hepatitis C had been cured. To combat these concerning trends, the White House proposed a National HCV Elimination Plan in their budget for 2023-2034. Supporters of the plan, including CGHE, have mobilized to urge Congress to allocate funds for the program.

Plan Overview

The proposed plan has four key components:

  • Identify more cases by expanding access to single-visit, rapid results testing
  • Expand access to care by eliminating burdensome requirements for people using Medicaid 
  • Lower costs by establishing a subscription model wherein the government negotiates lump some medications (aka, “Netflix” model)
  • Invest in community health programs that are best suited to deliver care while also working to develop a hepatitis C vaccine

Cost and Lives Saved

After a request from the White House, CGHE partnered with Jagpreet Chhatwal at the Institute for Technology Assessment at Massachusetts General Hospital and Harvard Medical School to perform an analysis of the proposed plan to estimate cost and lives saved. This data was used by the Congressional Office of Management and Budget to demonstrate that the national plan to eliminate hepatitis C could save more than 90,000 lives and nearly $60 billion by 2050.

NBER headline

Ensuring Equity

CGHE director John Ward co-authored a “Viewpoint” article in the Journal of the American Medical Association, published in April 2023, arguing that the US must strive to address health disparities in order to achieve elimination of hepatitis C: “Adopting policies that enable access to current approaches to prevention and treatment, although helpful, will not by themselves achieve health equity. We must also prioritize populations disproportionately affected by HBV and HCV, locate low-threshold prevention and care services in settings that serve persons with high disease burden, and ensure that the systems in place to treat infected individuals and care for at-risk populations do more than pay lip service to the social factors influencing health outcomes.”

The Right Thing to Do

CGHE believes that no one should have to suffer or die from hepatitis C. In the United States, one of the wealthiest and most scientifically advanced countries in the world, to see so much loss of life from a curable disease is unconscionable. When Dr.’s Michael Houghton, Harvey Alter and Charles Rice were awarded the Nobel Prize for their discovery of the hepatitis C virus in 2020, they set the stage for a cure that should be accessible to all. 

Now they are speaking out in support of a national plan: “At the time of our award, the Nobel Committee recognized the immense potential gains in human health stemming from our discovery of hepatitis C virus and the tests and treatment that followed: 

It is now possible, for the first time in human history, to foresee a future where the threat of this virus infection is substantially reduced and hopefully soon eliminated.  

We could not agree more. All of the essential ingredients needed to realize the future envisioned by the Nobel Committee are in place save one: a national commitment to eliminate hepatitis C.”

John Ward quoted in PBS NewsHour


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More about the Proposed U.S. HCV Elimination Plan

The 2024 budget proposed by the White House sets aside $12.3 billion over the next 10 years to eliminate hepatitis C. Right now, as Congress is considering the proposed spending, which would expand testing, increase access to antiviral drugs, and lower the cost of treatment. 

Page 79 of the proposed budget explains: “The Budget includes a new mandatory proposal for a national program to significantly expand screening, testing, treatment, prevention, and monitoring of Hepatitis C infections in the United States, with a specific focus on populations with high infection levels. This program would support Federal procurement of life-saving treatments, while bolstering provider capacity and related public health efforts such as testing, communication, and surveillance.

View the President’s 2024 Budget

More about Medicaid Restrictions

Restrictions for Medicaid recipients within the U.S. have limited persons living with hepatitis C access to necessary treatments and care. The Center for Health Law and Policy Innovation of Harvard Law School and the National Viral Hepatitis Roundtable (NVHR) have advocated to ensure that all persons in the U.S. living with hepatitis C have access to treatments with the Hepatitis C: State of Medicaid Access Project. Since the start of the project, 21 states no longer require prior authorization for most patients, 33 states have completely removed or limited fibrosis restrictions, 36 states have reduced sobriety restrictions, and 35 states have loosened prescriber restrictions.

Although significant progress has been made towards reducing and/or eliminating Medicaid restrictions, there is still work to be done to ensure a cure for HCV is available to everyone.

Read more on the 2023 National Snapshot Report

What can I do to help?

Contact a member of Congress in support of the U.S. National Plan: Download a sample letter.

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Last day updated 18 Aug 2023