INDIANAPOLIS – Indiana is ramping up the fight against hepatitis C.

The chronic liver infection is both a problem in its own right and a leading indicator for H-I-V outbreaks. Both viruses are spread by contaminated needles, and people with one often contract the other. Hep C cases have tripled in Indiana in the last four years, a byproduct of the opioid epidemic.

The liver disease is treatable with medication, but those drugs are expensive. Like most states, Indiana has authorized Medicaid coverage only for patients who already have advanced liver damage. That requirement goes away starting Monday. Family and Social Services Secretary Jennifer Walthall says a growing body of medical literature makes clear that delaying treatment leads up to more liver damage.

Also taking effect Monday is the new state budget, which increases Medicaid spending for hep C by 400-million dollars over two years — enough to treat more than seven times as many patients. The department’s also working to expand hepatitis C screenings in populations with high numbers of drug abusers. The state already screens at certified methadone clinics, and is working to expand screenings at jails, prisons, and mental health centers.

There are also limits on who can legally prescribe the medication. 28 providers are in training at I-U to increase the number of certified providers.

Walthall’s enthusiastic about a just-announced program in Louisiana to pay drugmakers a flat amount for an unlimited supply of anti-hepatitis drugs — Walthall dubs it “the Netflix plan.” But she says Indiana won’t be following suit immediately. She says the up-front cost is high, and Indiana needs better screenings and more prescribers in place before it could even consider whether the plan makes financial sense.

 

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