Court of Appeal upholds rationing of hepatitis C treatment

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CINCINNATI (AP) – The Kentucky Department of Corrections can deny inmates a life-saving but expensive hepatitis C drug, a federal appeals court ruled in a split decision. The dissenting judge in last week’s 2-1 ruling from the U.S. 6th Court of Appeals said the majority opinion would sentence hundreds of prisoners to long-term organ damage and suffering. term, reported the Courier-Journal..

Hepatitis C is the leading cause of liver transplantation and severe liver disease, including cirrhosis and liver cancer, and Kentucky has the highest infection rate in the United States. Newer treatments can cure almost 100% of patients, but cost $ 13,000 to $ 32,000. Because they are so expensive, the Kentucky Department of Corrections has limited the use of the treatment to inmates with advanced liver scarring or fibrosis.

The majority found that denying treatment to most of Kentucky’s 1,200 inmates with hepatitis C does not violate the Eighth Amendment ban on cruel and unusual punishment.

Lisa Lamb, a spokesperson for the Corrections Service, said its policy aligned with the practices of the US Bureau of Prisons, and two courts have now concluded that the ministry does not violate the constitutional rights of prisoners.

Louisville attorney Greg Belzley, who represents the prisoners in the class action lawsuit, called the decision “horrific” and said they would seek a new full court hearing or ask the Supreme Court for United States to hear the case. “Basically the majority… decided that Kentucky prison officials had nothing to do to deal with an inmate’s infection other than sit back and watch it get worse,” he said. to the journal in an e-mail.

Belzley said the department does not treat any infected inmate until their liver has already become cirrhotic, and although hepatitis C is curable, cirrhosis is not. He said that in August 2019, the latest figures available, the department had identified 1,670 prisoners as HCV positive. Only 159 had received treatment.

Belzley said it would cost taxpayers less to treat infected inmates in prison than to wait for their release. During this time, they probably infect other people before they finally receive treatment.

In a clearly worded dissenting opinion, Judge Jane Stranch said Kentucky’s rationing plan “shocks conscience” and is fundamentally unfair. She noted that the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, the Department of Veterans Affairs, and even Kentucky’s own Medicaid system recommend treatment with direct-acting antivirals, or DAAs, regardless of the condition. degree of fibrosis.

“Yet, according to the defendants themselves, they chose not to administer DAA to all detainees due to the cost of the drugs, a decision that exposed the detainees to continued suffering and long-term organ damage. . ”

The majority opinion upheld an earlier ruling by U.S. District Judge Gregory F. Van Tatenhove of Lexington, who held that the department’s monitoring of inmates with hepatitis C was treatment and the department’s treatment plan was adequate.

Quoting Merriam-Webster’s definition – “the act of treating a patient or condition medically or surgically” – Stranch wrote in his dissent that “testing how far HCV has progressed in destroying the body of an inmate n ‘is not a cure’.

The case was initially filed on behalf of four inmates who contracted the virus – Brian Woodcock, Keath Bramblett, Ruben Rios Salinas and Jessica Lawrence. While the first two have been cured, Salinas has been denied treatment and Lawrence has yet to receive it, according to court documents.

The department previously refused to process anyone who had not had a clear criminal record for 12 months, but after filing the complaint, it changed the rule to only cover offenses that could jeopardize treatment.


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