In class-action settlement, Minnesota prisoners win access to pricey hepatitis C drugs

Minnesota prisoners with chronic hepatitis C infections must be provided with highly effective but costly antiviral drugs following a class-action lawsuit settlement.

A group of five inmates infected with the virus sued the Department of Corrections in 2015, accusing the agency of withholding the new drugs from them despite the medications having a 95 percent cure rate.

"The settlement will provide a cure to all prisoners at every stage of progression," said Andrew Mohring, an attorney for the prisoners. "It puts Minnesota in the forefront for treatment and care of its prisoners who have chronic hepatitis C."

The prisoners were not awarded any money as part of the settlement. However, the DOC must reimburse their attorneys $325,000 in fees and another $41,000 in costs. The medications, known as "direct acting antiviral" (DAA) drugs, range in price from $26,400 to more than $100,000 per patient. In court filings, the DOC has said that providing the drugs to all infected inmates could "result in a fundamental alteration to the DOC or its programming" because of the expense.

Under the terms of the settlement, which won preliminary approval on Monday, the DOC must screen all prisoners for hepatitis C. Antiviral drugs must be provided if the inmate has an advanced stage of the disease or has hepatitis along with other complications, such as another viral infection, diabetes or a liver transplant.

An inmate denied treatment can request a re-evaluation every six months. Any inmate with the virus will get treatment after 16 months' imprisonment.

"Hepatitis is a slow progressing condition that can cause liver disease," DOC spokesman Sarah Fitzgerald said in a statement. "While the department has been providing medically appropriate care to offenders who have chronic Hepatitis, we will change our practice — even if they have not developed liver disease."

The litigation joins a series of similar lawsuits across the country that ask whether prison inmates have a right to the most effective drugs despite the toll on the corrections budget. The lawsuit alleges that, although some inmates were getting the new drugs, the DOC's medical guidelines conflict with the medical standard of care endorsed by "practitioners, major medical associations, and care providers" that requires testing and immediate treatment of all patients with chronic hepatitis C, with limited exceptions.

The DAAs, first approved by federal regulators in 2013, have fewer side effects than older treatments and only require taking a pill once or twice daily for up to 12 weeks.

Private and government health insurers have increasingly agreed to cover the drugs for patients suffering from all levels of hepatitis C, a contagious disease that attacks the liver. Hepatitis C typically spreads by blood through needles or sexual contact.

Left untreated, hepatitis C can cause severe liver damage and cancer. About 75 percent to 85 percent of people who have hepatitis C will develop a chronic infection, according to the Centers for Disease Control. Some of the inmates in the lawsuit said they were infected with hepatitis C while incarcerated.

A previous court filing from the prisoners estimated that there 3,500 inmates with a hepatitis C infection, though in a statement the DOC said 100 prisoners were treated a year, a number that could double.

In previous court filings, the DOC said it had already been treating some inmates with advanced stages of the disease with the costly antiviral drugs, spending $1.6 million during a nine-month period from 2016 to 2017. Still, providing the drugs to all inmates with the virus "would eclipse some correctional systems' budgets by a factor of three," wrote Assistant Attorney General Kathryn Fodness.

In an order, U.S. District Judge Patrick Schiltz found that the DOC was essentially telling its inmates that they wouldn't be treated until they suffered liver damage.

Staff Writer Stephen Montemayor contributed to this report. Brandon Stahl • 612-673-4626