Hepatitis C: New Mexico and National Epidemic

One of the most pernicious and fastest-growing public health problems in the United States today is Hepatitis C, a viral infection that may be carried by people for years without the carrier being aware. New Mexico has one of the highest rates of Hepatitis C infection in the United States and the problem only promises to worsen. By every measure, it has become an epidemic.

A National Epidemic

Currently, there are over 3,000,000 people with chronic Hepatitis C in the United States. There are many more people who have contracted the virus but who are unaware that they are carriers. Each year, more than 17,000 people contract the virus according to the Department of Health and Human Services (HHS)[1]. According to the Centers for Disease Control (CDC) more people die each year from Hepatitis C than any other infectious Disease. Large numbers of those infected are from the so-called “Baby-Boomers” generation-people born between 1945-1965-who were unknowingly infected through transfusions given during medical procedures after WWII.

Many people walk around for years completely unaware that they are infected with the virus, transmitting it to their domestic partners. Aside from sexual transmission, large numbers of those who engage in intravenous drug use are also infected through the use of shared syringes. They also go on to infect their partners. By every measure, Hepatitis C represents a large-scale public health threat. The Centers for Disease Control (CDC) provides an overview of Hepatitis C including more detailed statistical information for those who would like additional information.

Can the Infection Be Treated and Cured?

Prior to 2013, treatments such as Interferon which utilized radio-isotopes similar to chemotherapy for cancer patients, were prohibitively expensive, lengthy, painful and offered rendered those being treated incapable of doing much during the course of their treatment regimes. Often, these treatments lasted as long as a full year and were not always effective. In 2013, with the advent of the first anti-viral drugs were developed and hit the market. However, these new drugs were prohibitively expensive, and many insurers balked at payment for treatment. The cost of these new drugs has been reduced, incrementally, with each successive year. One of the most popular and effective drugs, Harvoni, once cost well over one hundred thousand dollars per patient but now costs twenty-thousand or less and continues to decrease in price

Hepatitis C (HCV) in the State of New Mexico

In a report issued in 2016 by the New Mexico Department of Health (NMDOH) there were 45,000 people living with chronic Hepatitis C. Of these, approximately 11,250 will develop cirrhosis and 2,250 will develop liver cancer. Roughly have of those with chronic HCV are unaware that they are carrying the viral infection.

The report goes on to estimate that 27,000 to 67,500 people in New Mexico are HCV antibody positive and 23,000 to 55,000 are currently infected. Again, thousands of people are carriers but are unaware that they have been infected. Unknowingly, they in turn infect their partners and the numbers increase yearly as a result.

Geographically within the State, the rates of infection vary considerably with Northern and Western counties having the highest concentrations of infected people. This geographic dispersion poses another set of problems, the availability of specialists and access to treatment.

“New Mexico is a geographically large, population dense state. The majority of specialists who have the skills and capacity to treat hepatitis C practice in the Albuquerque metropolitan area. Thirty-two of New Mexico’s thirty-three counties are defined as medically underserved. The lack of physicians trained to manage and treat HCV is particularly significant in rural areas. For those who are referred to specialists, waits for appointments may take months.”

In addition to the geographic barriers that have historically limited people’s access to treatment in our state additional barriers have been presented by insurance covering costs. In the case of coverage for treatment costs by Medicare and Medicaid whose provisions for the coverage of treatment contradicted public policy, some relief was granted on November 15, 2015 when the “Centers for Medicare and Medicaid Services (CMS) recognized that restrictions on HCV treatment in place among State Medicaid programs around the country were illegal”. They subsequently issued guidance to states on coverage for HCV treatment.

New Mexico implemented changes to its HCV treatment policy on December 1, 2015. In addition to changes to the State’s Medicaid provisions, there has been a concerted effort to expand testing and treatment. In 2016, New Mexico fielded its Statewide Comprehensive Plan.

Community Efforts to Address the Hepatitis C Epidemic

The aforementioned plan “Hepatitis C Virus (HCV) in New Mexico: Comprehensive Statewide Plan and Profile of the Epidemic” provides a very detailed plan of action for the address of the problem in our communities. The mission statement of the plan and participating members is as follows:

“New Mexico will prioritize the prevention, testing and treatment of infection with hepatitis C virus (HCV) in order to reduce the number of new infections, as well as, cure the infection in those currently living with HCV, thereby reducing the negative health impacts of this disease.”

A very important component within the State’s Plan has been Project ECHO. Project ECHO began in New Mexico in 2003 out of the University of New Mexico Health Services Department and it has sought to expand testing, treatment and education efforts throughout the state. Its success has been widely noted.

Hepatitis C in New Mexico’s Prison System

According to multiple sources, the number of inmates within New Mexico’s eleven State Correctional Facilities infected with HCV exceeds 40%, over 3,000 people. Of the 3,000 diagnosed with HCV in the system only 46 received any kind of treatment.

As aforementioned, the cost of antiviral drugs are now considerably cheaper. Nevertheless, in 2019 the New Mexico Corrections Department and its medical contractors only managed to treat 90 inmates, in spite of considerable fiscal outlays. It remains baffling as to just how few people have received treatment.

If you know someone who is incarcerated in New Mexico and who has been diagnosed with Hepatitis C but who has not been treated you should contact Collins & Collins, P.C. If this viral infection is allowed to progress to such point as he or she has developed cirrhosis-liver disease or liver cancer (Hepatocellular Carcinoma) you should seek an experienced and practiced attorney who will be able to properly evaluate the case.