A Maine prisoner with hepatitis C is suing the state Department of Corrections and a prison medical provider to force officials to offer a costly but almost universally effective cure for a disease that infects nearly a quarter of the state’s prison population.

Mathiew Loisel, 34, who is serving a 30-year sentence for murder at Maine State Prison in Warren, is the lead plaintiff in a class-action lawsuit filed in U.S. District Court on Tuesday against the Maine Department of Corrections, the corrections commissioner, and prison medical provider Wellpath, LLC, and others, seeking a court order that would force the state to offer a cure to more than 500 prisoners who have hepatitis C.

Loisel alleges that prison policy of withholding the cure until after a prisoner has already suffered permanent liver damage is motivated by a desire to contain medical costs, and fails to provide adequate care for sick prisoners in violation of their rights. Treatment comes in a pill form and is taken daily for up to three months, often at a cost of tens of thousands of dollars.

The lawsuit alleges that one treatment provider at the Maine State Prison told him during a consultation in January 2018 that “the costs of these drugs is just too high” and that the prison “cannot possibly treat everybody.” This practice amounts to a violation of the Americans with Disabilities Act and Loisel’s constitutional right to due process, and protection against cruel and unusual punishment, his attorney argues.

“The fact that the drug is expensive is not an excuse not to treat someone for a disease,” said Taylor Asen, an attorney with Berman & Simmons, who is among the team of four attorneys representing Loisel. “We don’t think that the price of the drug is an adequate excuse, particularly when we as a state have already committed to providing this drug (through MaineCare) to poor people who cannot afford their own insurance.”

States across the country are grappling with the same problem of coming up with the money to treat poor or incarcerated people with the costly medication, sometimes denying or rationing care to manage the price.

Attorneys for Loisel say they believe his chance of success is improved under the administration of Gov. Janet Mills and Maine Attorney General Aaron Frey, who they hope will be more receptive to changing prison policy. Emails requesting comment on the suit were not returned by a spokesman for the Office of the Attorney General, which defends all lawsuits against government entities. An email to Corrections Commissioner Randall Liberty also was not returned.

Hepatitis C is a blood-borne viral infection of the liver that is often transmitted by drug users who share needles or otherwise come into contact with an infected person’s blood.

While some people who are infected with the disease suffer only a short illness, the majority – at least three quarters of the roughly 3.4 million Americans who have been diagnosed, according to the Centers for Disease Control – develop a chronic version that was believed to be incurable. But in 2011, drug makers released a new treatment method known as direct-acting antiviral medications, which completely cure nearly all variations of the disease and reduce someone’s risk of developing serious complications later.

Loisel was diagnosed with hepatitis C in 2014 and alleges that since then, medical staff members have repeatedly refused to provide the cure because his liver is not yet damaged enough, according to a single medical test, the suit alleges.

In the suit, Losiel is seeking a change in state policy to treat all infected prisoners, and an award for his attorneys fees. He is not asking for damages or any monetary award. The case follows a similar lawsuit decided in March, in which a federal judge ordered administrators at the Aroostook County Jail to provide a woman serving a short sentence there to continue providing Suboxone as part of medication-assisted treatment for opioid use disorder.

In that case, the jail argued that bringing such drugs into the facility posed a security and diversion risk. But the judge found that denying the woman a course of treatment she was already receiving at a doctor’s recommendation before her sentence and that she planned to continue after her release would cause “serious and irreparable harm,” and violated the Americans With Disabilities Act.

As of October 2017, 580 Maine prisoners were diagnosed with hepatitis C, according to a survey performed by an independent journalist, whose freedom of access act request and the state’s response is included in the lawsuit. Maine currently has nearly 2,300 people in state custody. This population does not including county jails, whose inmates are serving short sentences or who await trial.

In the case of hepatitis C in prisons, according to the 2017 FOAA response, corrections staff treated only three prisoners with hepatitis C-curing medication, and one of them was administered the drug because he was already in the midst of treatment when he went to prison.

Miriam A. Johnson, another attorney for Loisel, said the Aroostook County case was fresh in her mind when Loisel approached her firm about representing him.

“I said, ‘Hmm that’s awfully similar,’ and I realized, ‘Wow that is quite similar,'” Johnson said in a phone interview Wednesday evening.

Loisel alleges that Wellmark, LLC, the medical provider at Maine State Prison, uses a single, unreliable medical test as a marker for whether someone with hepatitis C receives treatment. That test measures damage to someone’s liver, known in the early stages as fibrosis and in later, serious stages as cirrhosis. But that test does not catch every case of serious liver damage, and is therefore an unreliable yardstick of who should be treated, Loisel argues.

Attorneys for Loisel say the practice of withholding treatment also endangers the general public.

Prisoners with hepatitis C have a higher risk of exposing a greater number of people to the disease after they are released. And because most people with hepatitis C are involved at some point are incarcerated, state government is missing an opportunity to treat the most at-risk population of people while they serve prison sentences.

“This is not a case that requires a complicated remedy,” said Asen, one of the attorney’s representing Loisel. “This is a very simple remedy. Just treat people with the drug that they should be treated with.”

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