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House Co-Sponsorship Memoranda
House of Representatives
Session of 2013 - 2014
Regular Session
MEMORANDUM
| Posted: | December 24, 2013 10:28 AM |
|---|---|
| From: | Representative Matthew E. Baker |
| To: | All House members |
| Subject: | Hepatitis C Legislation |
| I invite your co-sponsorship of Hepatitis C Screening Legislation. Your help is needed to confront hepatitis C (HCV), a looming public health epidemic for the largest demographic in U.S. history – the Baby Boomer generation – that also represents a major health disparity that cruelly impacts communities of color in a very pronounced way and is a scourge for many veterans of the U.S. Armed Forces, particularly from the Vietnam War era. Bottom line: Timely Bi-Partisan Leadership and Action Needed to Address Hepatitis C Epidemic in Pennsylvania Like New York, Pennsylvania unfortunately has one of the highest rates of hepatitis C in the nation. The good news is that there is now hope as this silent and often deadly infectious disease can now be increasingly cured. However, your help is needed to ensure that public policy keeps pace with biomedical innovation. You may recall, that in May 2012, during National Viral Hepatitis Awareness Month, the Pennsylvania Department of Health commendably hosted the first hepatitis C Roundtable in state history (PA’s Departments of Aging, Corrections, Drug & Alcohol, Insurance and Public Welfare participated as did some of members of the Legislature, the Adult Viral Hepatitis Prevention Coordinators for Philadelphia and Pennsylvania, patient advocates, providers and industry). This strategic, public-private dialogue resulted in a number of important milestones – most notably, the elimination of longstanding and unnecessary regulatory barriers to HCV field screening and testing. Prior to this meeting, HCV mobile field testing was not permissible in Philadelphia or Pennsylvania. What Can You Do Right Now to Stem the Hepatitis C Crisis for the Baby Boomer Generation? You can collaborate with your fellow legislators and co-sponsor simple, straight forward legislation that will codify the CDC’s birth or age cohort screening guidelines (such were released by the CDC in August 2012 and call for anyone born between 1945-1965 to be tested for hepatitis C as 3 out of 4 with chronic hepatitis C were born between these years). The status quo or current approach to hepatitis C testing is unacceptable. We simply can’t have 3 out of 4 persons who are infected with this virus not know it, especially since biomedical innovation now offers more than just hope, it offers a cure. As a nation and state, we can do better. This crucial policy initiative is one irrefutable way that can most immediately help patients in Pennsylvania that are afflicted by this deadly but now, increasingly curable disease. However, they can’t be helped if they don’t know that they have a silent disease. Why Should You Do So? There is a moral imperative to act. With timely, bi-partisan leadership, you can and will save the lives of many Pennsylvanians who do not presently know that they are afflicted by this disease. 3 out of 4 persons (75%) of those who have this infectious virus do not know it (note: there is a vaccine for hepatitis A and B but not C; however, there are now cures available for hepatitis C but not for A or B). Hepatitis C, the most common blood borne disease in the U.S., is the leading cause of liver cancer and liver transplantation. And, as of 2007, more people are dying each year in the U.S. from hepatitis C than from HIV/AIDS (shockingly, the mortality rate is now 4 to 5 times higher). Many of Pennsylvania’s legislators are Baby Boomers, honorably discharged veterans and persons of color. Your leadership is simply needed at this time. The AARP and more than 40 state and national organizations strongly supported this bi-partisan legislation that was overwhelmingly approved by the New York State Legislature this past June. NYS Assembly: http://assembly.state.ny.us/leg/?bn=A01286 NYS Senate: http://assembly.state.ny.us/leg/?term=2013&bn=S02750 CDC and Viral Hepatitis Action Coalition (VHAC) Recognized NYS Assemblyman Ken Zebrowski (D) and NYS Senator Kemp Hannon (R) as part of World Hepatitis Day: http://www.cdcfoundation.org/pr/2013/leaders-honored-cdc-efforts-combat-viral-hepatitis Note: Hepatitis C screening/testing legislation was recently overwhelmingly approved by the NYS Legislature, by a margin of 138-1 in the Assembly (Democratic majority) on June 10 and by a 63-0 margin in the Senate (Republican majority) on June 20. If signed into law, as is expected, this truly patient-centered legislation will give teeth to the CDC’s age or birth cohort HCV screening guidelines that were released in August 2012. In short, the CDC’s guidelines recommend that all persons born between 1945 & 1965 be screened for HCV. In doing so, the NYS Legislature has helped to create widespread awareness of hepatitis C as a mainstream, public health epidemic. So, if you follow suit in Pennsylvania, you can simply have the certitude of knowing that you and your colleagues took a courageous, necessary and affirmative step in changing the trajectory of a looming public health epidemic that is a silent killer of the largest demographic in American history, the Baby Boomer generation. The Association of State and Territorial Health Officials (ASTHO) which represents the nation's public health leadership, the CDC, the Council of State Governments and the National Black Caucus of State Legislators (NBCSL) are poised to champion this critical legislation in states with a known high prevalence of hepatitis C. Pennsylvania has been a trailblazer in public health and infectious disease. It is needed to be again. A generation ago, HIV/AIDS was a certain death sentence yet today it is a manageable but difficult chronic disease. Biomedical innovation and timely policy change helped to ultimately bring about this outcome. Academic medical research institutions and the physician community were of course an integral part of this sea change; however, it was the courage of policy makers and legislators as well as the persistence of grass-roots advocacy that most dramatically prompted this change. The hepatitis C epidemic demands no less. Doesn’t this Legislation Represents Another Unnecessary Mandate? Wrong. The Centers for Disease Control and Prevention (CDC) and the United States Preventive Services Task Force (USPSTF) both now support this approach to screening and testing for this birth-cohort population (that those born between 1945 & 1965 should be tested). Since most insurance coverage decisions are based off of USPSTF recommendations, it is no longer an open question as to whether or not insurance will cover the costs for testing. Plus, the CDC and the Annals of Medicine have already published a comprehensive, peer reviewed study that has concluded that this birth cohort approach is cost effective? Why? Because, left unaddressed, the societal costs to treat liver cancer and for liver transplantations over the next couple of decades will be staggering. Bottom line, this limited approach is for a very defined population for a limited time. It is reasonable, narrow in scope, necessary and cost-effective (if this epidemic is left unaddressed and the Boomer population left untested, total annual medical costs for patients with hepatitis C are projected to increase from $30 billion a year in 2009 to over $85 billion in 2024). So, What Would this Legislation Accomplish? If enacted into law, such a measure would require health care providers and hospitals (in the in-patient and out-patient settings) to screen those in this designated birth cohort (born between 1945 and 1965). If such persons provide their consent, they would be required to be tested for HCV or referred for testing). It is also time for the primary care community to be fully assimilated into the clinical treatment of this mainstream disease which heretofore, has mostly remained in the exclusive province of hepatologists, infectious disease specialists and gastroenterologists. Please let me know if I can be of any assistance in sending to you more details and documentation about this life-saving, patient centered legislation. |
Introduced as HB2003