The mass screening campaign has already drawn criticism in a leading medical journal. “The desire to treat patients to prevent these consequences is great. But the treatments that we have had available are not very effective in clearing the infection, result in serious adverse effects including making patients feel sick during a prolonged treatment course, and are expensive,”
Dr. Mitchell Katz, director of the Los Angeles County Department of Health Services, wrote in a JAMA editorial published in February. “For these reasons, neither I nor my patients have been very enthusiastic about treatment.”
The call for mass screening comes just as drug companies are pushing to bring new medications to the market. Besides the Food and Drug Administration's approval in December of Gilead's combination antiviral treatment regimen Sovaldi, AbbVie announced positive results for its investigational therapy at the Conference on Retroviruses and Opportunistic Infections in Boston last week.
The company's pivotal phase III study showed that the therapy could cure 99% of hepatitis C infections in some patients. Bristol-Myers Squibb, Roche and Merck also are racing to develop drugs.
The CDC is also collaborating with test makers to develop diagnostics that will more accurately identify which drugs will work best for which HCV-positive patients. Last July, the CDC and Quest Diagnostics announced a research program in which they would share data about diagnostic, genotyping and viral load tests clinicians use to manage treatment.
Medicaid payers already are fretting about the costs. The latest drugs such as Sovaldi are too costly to treat every potential patient, they say. The issue is such a concern that several groups, including Molina Healthcare, sent letters to state Medicaid offices in January requesting “emergency guidance” on how to handle “extraordinarily expensive” treatments.
“Cost for much of the care is going to fall back on the taxpayers, and at a time when we're struggling just to get people insured, that is problematic,” Molina said. “You could probably insure 25 people per year, just with what it would cost to treat one person with that drug.”
Follow Sabriya Rice on Twitter: @MHsrice