Recently, a federal judge ruled that the state of Washington’s Medicaid program must pay for the treatment of all of its Hepatitis C cases — not just the acute ones. This means that 28,000 people will be eligible for treatment. If treatment is with the drug Harvoni, it will cost $95,000 for the 12-week plan. Multiply that out and you are looking at, potentially, a cost of $2.6 billion — three times the entire drug budget for the state. This drug, among a couple other new products, is 90 percent effective. With insurance companies being pressured to do the same, one can see some major expenses being incurred.

Hepatitis C (HCV) affects the liver. Most people that get it do not show symptoms for years and when they do appear, it may be passed off as the flu. Sometimes, there is a yellowing of skin and eyes, dark urine or pale bowel movements. It may lead to liver disease, cirrhosis or liver cancer. It is usually spread through contact with infected blood. It is the No. 1 cause of liver cancer and liver transplants in the U.S. There is no vaccination against it.

Those at most risk were born between 1945 and 1965 (this is the largest infected population); have received a blood transfusion; have injected drugs; had exposures to infected blood through occupation, manicures, pedicures, piercings and tattoos; had combat exposure; have been incarcerated; were born to an infected mother; or received unsterile medical injections. Of special note is that the occurrence is 10 to 20 times higher than the general population for prison inmates and two to three times higher for tattooed people. Rarely is it thought to occur through sexual intercourse.

The relevance of this for Robeson County is that the state has identified three regions that have significantly higher levels of HCV than the others; two in the Far West and one in the Southeast, which includes our county. Heightened efforts to test will begin soon and there are some rebate programs that will assist in the treatment phase. This condition transcends the usual labeling of the infected people as it is prevalent throughout the population. For instance, it was common for the Vietnam-era soldiers to receive their overseas vaccinations via an air gun that was not cleaned properly between soldiers. Of course, we don’t have to go quite that far back as swine flu shots were given with air guns while I worked in South Carolina. A blood test can be conducted by your medical provider to ascertain your results. You should be hearing more about the program after the roll-out.

Bill Smith
https://www.robesonian.com/wp-content/uploads/2016/06/web1_Bill-Smith_cmyk.jpgBill Smith
Southeast identified as high risk

Bill Smith

Bill Smith is the director of the Robeson County Health Department.