State seeks reversal of prison hepatitis ruling

TALLAHASSEE, Fla. – The Florida Department of Corrections this week asked a federal appeals court to overturn a ruling that requires the state to provide costly treatment to inmates who have been diagnosed with the early stages of hepatitis C.

The department, represented by Attorney General Ashley Moody’s office, filed a brief Monday at the 11th U.S. Circuit Court of Appeals, as it battles a ruling by Chief U.S. District Judge Mark Walker that required the treatment for all inmates with the contagious liver disease.

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The state does not dispute that the treatment, which involves medication known as “direct acting anti-virals,” should be provided to inmates with later stages of hepatitis C. But attorneys contended in the brief that the state would not violate the Eighth Amendment ban on cruel and unusual punishment if it did not provide the medication to prisoners in the early stages.

“This appeal raises the question whether the Eighth Amendment requires the Florida Department of Corrections to treat inmates with early-stage hepatitis C with a newly developed, yet expensive, course of treatment,” the 37-page brief said. “The new treatment, direct acting anti-virals, can be lifesaving for those suffering from moderate-to-severe hepatitis C. By contrast, medical studies have not established that DAAs (direct acting anti-virals) materially improve the mortality rate or quality of life for those diagnosed with early stage hepatitis C. Instead, adequate care for those individuals involves monitoring the disease’s progression and administering DAAs if it becomes medically necessary.”

But Walker, in an April 18, ruling, wrote that even inmates with no or mild liver scarring “have serious medical needs, FDC (the Department of Corrections) is aware of those needs, and FDC’s decision not to treat those inmates -- without any medical reason for that decision -- constitutes deliberate indifference.”

The drugs involved in the treatment cost $25,000 to $37,000 per patient, and the state argued in this week’s brief that the Eighth Amendment does not bar it from considering costs in making treatment decisions.