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Lawmakers to NY Docs: Screen All Baby Boomers for Deadly Liver Disease

Monday, July 01, 2013

New York could become the first state to mandate that doctors make testing for hepatitis C, a deadly and widespread liver disease, a routine part of healthcare for baby boomers.

The influential U.S. Preventive Task Force last week recommended primary care doctors, such as internists and gynecologists, offer screening for the virus to all patients born between 1945 and 1965.

A bill recently passed both houses of the New York legislature that would give those guidelines the weight of law and penalize physicians who don’t offer the Hepatitis C test to patients in this age group. It would be up to patients to decide whether they actually want to take the blood test.

Assemblyman Kenneth Zebrowski (D-New City), the bill’s author, said state government has a role to play in controlling the epidemic, and that advisory guidelines alone, even from a federal agency, are not strong enough.

“When you codify something, and it goes into the public health law, doctors will follow it,” said Zebrowski, whose father died of hepatitis C in 2007 from a blood transfusion decades earlier.

The Medical Society of the State of New York opposes the bill. The physicians group does not object to the actual screening requirement, but it says the law is structured in impractical ways—and that health experts, not politicians, should create health regulations.

The bill is on the desk of Gov. Andrew Cuomo, who has not indicated whether he supports it.

For years, doctors mainly offered tests for the virus to at-risk populations, including IV drug users and people who recalled having blood transfusions prior to 1992. That is when the first screening test was implemented, effectively eliminating hepatitis C from the nation’s blood supply. Prior to the new consensus, experts believed widely testing other groups would cost a lot and not pick up many infections.

The Centers for Disease Control and Prevention now says there is strong enough evidence that baby boomers do not know enough about the health care they received in the 1970s and 1980s—including whether they received transfusions or were exposed to blood in other ways—that it would be worth screening the whole age group.

The hepatitis C virus attacks the liver but it typically takes decades for external symptoms to emerge. The CDC estimates 3.2 million people are infected. Other estimates go as high as 8 million, with as many as three-fourths of those people unaware that they are carrying the virus.

New medications for hepatitis C have improved treatment and reduced side effects, and more are in the development pipeline. Manufacturers of drugs and tests—all of which could benefit from a broader screening regimen—include Bayer, Merck, Vertex, Gilead, AbbVie, Orasure, Abbott Laboratories and Ortho Clinical Diagnostics, a subsidiary of Johnson & Johnson.

Johnson & Johnson has contributed $250 recently to Zebrowski’s campaign committee. His office said the donation is the only one he received from a company with hepatitis C products and came unsolicited, after the bill was passed. Several of the companies, including Abbott, Johnson & Johnson and Merck are regular donors to state politicians.

Vertex Pharmaceuticals, a company based in Cambridge, Mass., with a new hepatitis C drug, made its debut as a giver to Albany in 2012. It has contributed $13,000 to legislators through January of this year, mostly through the Democratic and Republican Assembly and state Senate campaign committees. A handful of legislators received individual $500 donations, including Sen. Kemp Hannon (R-Garden City), chairman of the Senate Health Committee and the bill’s co-sponsor in the Senate.

Hannon's office declined to comment on the donation but said the bill is consistent with the recommendations of the city Health Department, the CDC and the Greater New York Hospital Association.

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Comments [3]

Heidi Siegfried from Brooklyn

My Doctor recommended a Hepatitis C Screening last September based on the then recent recommendations of the CDC that people in my age group get it. It took her only a minute to do it. The problem for me is that my insurance company UnitedHealthCare, does not wish to cover based on the outdated CDC recommendations that they continue to follow. Thanks to the Affordable Care Act (ObamaCare), now that the US Preventive Services Task Force has given this same recommendation as a Grade B recommendation, all insurance companies will be required to cover this preventive service -- and with no co-pay. The law provides that all preventive services with a USPTF Grade A or Grade B recommendation be covered without co-pays. Unfortunately there is a minimum interval between the date on which a recommendation is made and the plan year in which the Plan must cover it. Of course Plans could always choose to cover recommended preventive services earlier. But if you want to be sure that it will be covered and will be without a co-pay, wait until 2015.

Jul. 02 2013 10:23 AM
Brian

Grandpa Daniel: Get tested for hepatitis C! If you have it, you may want to get treated.

Jul. 01 2013 06:50 PM
Grandpa Daniel from Manhattan

NYC blood bank declined to accept my contribution in early 1980s because my blood contained antibodies from "non-A non-B hepatitis." Told me never to contribute again. What next?

Jul. 01 2013 01:12 PM

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