Hepatitis C Screening (Note)

Hepatitis C Screening (Note)
By Debra Miller, CSG Director of Health Policy

Hepatitis C is a liver disease that results from infection with the hepatitis C virus. It can range in severity from a mild illness lasting a few weeks to a serious, lifelong illness. Hepatitis C is usually spread when blood from a person infected with the virus enters the body of someone who is not infected. Today, most people become infected with the hepatitis C virus by sharing needles or other equipment to inject drugs. Before 1992, when widespread screening of the blood supply began in the United States, hepatitis C was also commonly spread through blood transfusions and organ transplants.

There is no vaccine to prevent hepatitis C. Vaccines are available only for hepatitis A and B. The best way to prevent hepatitis C is by avoiding behaviors that can spread the disease, especially injection drug use.

Also according to the CDC, an estimated 3.2 million persons in the United States have chronic hepatitis C virus infection, though most infected people do not know they are infected because they don’t look or feel sick. Approximately 75 to 85 percent of people who become infected with the hepatitis C virus develop chronic infection.

Two new drugs approved by the FDA in late 2013, have cure rates between 90 and 95 percent and treatment regimens with far fewer side effects than earlier treatments. However, the estimated cost for treatment is $1,000 to $2,000 a day, with a 12-week course costing between $84,000 and $168,000 per patient. States and insurance companies have made various decisions to target the expensive drugs for patients at later stages of the disease.  

During the 2013 legislative session, the New York State Legislature passed a first-in-the-nation law (Bill A1286A) requiring that hospitals offer hepatitis C screening tests for baby boomers (those born between 1945 and 1965). The New York legislation is in alignment with recommendations from the CDC released in August 2012.The bill is modeled after both federal guidelines and New York’s existing HIV testing law and requires hospitals and health clinics to offer hepatitis C testing to baby boomers, the age group with the highest infection rate. In June 2013, the U.S. Preventative Services Task Force, USPSTF, issued its final recommendations for screening for hepatitis C virus infection consistent with those of the CDC. The USPSTF recommends screening for hepatitis C virus infection in persons at high-risk for infection and recommends offering one-time screening to all adults born between 1945 and 1965.

Since the passage of the legislation in New York, lawmakers in Connecticut (CT HB 257 (2014) CT ALS 203) and Massachusetts (MA Chapter 165 of 2014 Acts) also have passed legislation requiring hepatitis C virus screening to be offered to individuals born between 1945 and 1965. 

A 2014 Colorado law (CO SB 14-173) recommends, but does not require, that health care providers offer hepatitis C screenings to people born between 1945 and 1965.

In 2015, the Illinois governor vetoed a bill (IL S 661) to require screening. In addition, four states took up bills in 2015 to address hepatitis C virus screening but failed to pass them.

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