The Veterans Affairs Department will begin providing hepatitis C treatment to all veterans in its health system who have the virus, regardless of their disease stage, VA officials said Wednesday.
Having received a boost in funding from Congress late last year for the costly medications needed to cure hepatitis C, the VA is now able to treat the 174,000 veterans in its health system who have the disease, according to a VA release.
VA Under Secretary for Health Dr. David Shulkin said that while the cost previously was too prohibitive to treat all but the sickest patients, VA now can treat all veterans with the virus who are eligible for VA health care, either in a VA facility or through the Veterans Choice program.
“We’re honored to be able to expand treatment for veterans who are afflicted with hepatitis C,” Shulkin said. “Additionally, if veterans are currently waiting on an appointment for community care through the Choice program, they can now turn to their local VA facility for this treatment or elect to continue to receive treatment through Choice.”
An estimated 200,000 veterans have hepatitis C, including 174,000 veterans enrolled in the VA health system. Hepatitis C is spread by shared needles or by contact with the bodily fluids of an infected person, and those most at risk include people who received a blood transplant or organ transplant before 1992, when widespread screening became available in the U.S.
Roughly 60 percent of veterans who have hepatitis C served during the Vietnam era.
Since 2014, VA has treated 42,000 hepatitis C patients with the medication sofosbuvir. In fiscal 2015, the department designated $696 million, or 17 percent of its total pharmacy budget, for the drug. It expects to spend $1 billion for medications containing sofosbuvir in fiscal 2016.
California-based Gilead Sciences, the maker of the sofosbuvir, including brand names Sovaldi and Harvoni, has come under fire from lawmakers, who have accused the company of price-gouging.
The company had been charging the federal government up to $68,000 for a treatment regimen that costs about $1,400 to make. As a result, public health officials, including the VA, could afford to treat only the sickest patients.
The person who led the scientific team that created sofosbuvir, Raymond Schinazi, was a senior research career scientist who worked for the VA from the late 1980s until Feb. 1 of this year, when he retired from the VA.
According to a source with knowledge of the retirement, Schinazi requested his retirement on Jan. 21, the day the House Veterans Affairs Committee extended an invitation for him to testify on his role in developing the medication and growing the company that profited from its sales.
In an email exchange with Military Times, Schinazi said he had no knowledge of the congressional hearing when he submitted his resignation.
Schinazi continues to work at Emory University in Atlanta, Georgia, where he is director of the biochemical pharmacology lab. His research focuses on treatments for viruses including HIV, herpes, Dengue and Zika.
The Food and Drug Administration in January approved a different medication, Zepatier, made by Merck, to treat the disease. In a release on Wednesday, Merck executives said they priced the medication "to broaden and accelerate access to treatment for patients covered in commercial or public plans, including our country’s veterans."
“This is a good example of how government and industry can work together toward a shared goal in the best interests of public health — particularly for our veterans who are so deserving," Merck chairman and CEO Kenneth Frazier said.
A Merck spokeswoman said it was too early to tell whether Zepatier will become the favored treatment within VA to treat hepatitis C but that the company priced it appropriately to ensure that it could be accessed by all veterans.
In a statement released by Merck, VA Deputy Secretary Sloan Gibson praised the company for its role treating veterans.
“We are grateful to Congress and to pharmaceutical leaders like Merck that are committed to our veterans who have nobly served our nation," Gibson said.
Patricia Kime covers military and veterans health care and medicine for Military Times. She can be reached at firstname.lastname@example.org