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Louisiana's HCV Elimination Plan- ("Netflix" Model)
  Louisianna is one of several states that have what is called a "subscription" model of HCV elimination. they cut a deal on price with a drug manufacturer and resources are committed to screening, linkage & treatment. here is the Loisianna report on their subscription or Netflix model.
April 26 2022 at the CHAC meeting (CDC & HRSA Advisory Committee) there was a panel & discussion on HCV. The focus of the slide presentation was on the restrictions remaining & still imposed & the need to remove them. That is not new information, the current information is that there are model programs of HCV treatment designed for IDUs & HCV elimination plans ready to go in certain states & cities that are not funded; and that HCV screening is not fully funded. And that the CDC does not appear to be working adequately or closely or at all with many of these local DOHs in order to facilitate the implementation of these plans or to help further in local regions putting into pace the necessary means to address HCV elimination. With 40% unaware they have HCV & many IDUs unable to get screened or treated there is plenty of room to discuss all this & the barriers & the new models that address this. As well, death rates for HCV for older people and chronic infection rates for older people is underestimated and constantly overlooked, it is not only the young IDU that is the problem, its actually 50-50 in terms of old & new in chronic infections but it's the older people dying increasingly of HCV HCC, which means they are not tested & linked & treated well. And blacks & latinos are impacted in general the most in inner cities and that too is overlooked & not discussed. These model programs provide a full array of support services for IDUs which they need to enter a clinic for screening, care & treatment. EHRs can be utilized on the provider level to facilitate screening & treatment, this was raised by a clinical person not on the HCV panel. A question was asked if HCV screening during pregnancy was recommended but this was not adequately answered & discussed. The issue of screening came up after the HCV slide presentation & its clear that we need "real" screening mandates for all, this too was not addressed adequately. We need indeed a Ryan White Care Act type program for HCV, it would be time limited, not forever for maybe 5-6 years to eliminate HCV. But this too never came up. And the cost of treatment came up by someone calling HCV treatment "expensive" ! Ha ! Its $10k to $15k per course of treatment, this is the biggest bargain in healthcare, its a cure, a one-time cost, that saves many more times the cost of care if not treated. In contrast HIV costs $400k to care & treat a PLWH for 25 years, a lifetime expense. So again the people with HCV do not get their case very well stated. It's a disgrace that we have a cure for HCV and we can't fund HCV elimination which its estimated might cost $5 billion, which is nothing compared to what we spend on care for HCV & other diseases, its less costly to cure it than continue like this. People are dying, death rates due to HCV are increasing. Rome burns, the CDC & federal govt play the fiddle and everyone sits and watches.


Presented by: Anthony James, MS, MA, MSHCM Louisiana Office of Public Health STD/HIV/Hepatitis Program















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