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John Ritchie shouldn’t have died. He knew he had hepatitis C. And he knew, too, about the simple, once-daily pills that could fully cure him of the potentially deadly viral infection in about 12 weeks. But Ritchie was serving a 20-year sentence for armed robbery, and the Missouri Department of Corrections refused to treat him. (Florko, 12/15)

It’s virtually impossible to get information from states and correctional facilities about why people die in prison. For more than two years, STAT endeavored to document the number of incarcerated people who died due to complications from hepatitis C, part of a broad investigation into prisons’ failures to prevent avoidable death and suffering related to the condition. Prison systems fought our attempts at every turn. (Florko, 12/15)

In 2022, whether an incarcerated person gets cured of hepatitis C is largely determined by where they’re locked up. If you’re sentenced for breaking a state law in most of middle America, you’re likely out of luck. Iowa treated less than 4% of its hepatitis C-positive prison population last year with the new class of curative antiviral pills. South Dakota has a policy on the books that blocks treatment for anyone who doesn’t have serious liver damage. And Nebraska even forces people to sign forms acknowledging these drugs might not work — when they almost always do. (Florko, 12/15)

The only thing worse than caring for a sick loved one in prison is watching them die of a treatable condition, like hepatitis C. Families feel helpless as the symptoms escalate — the swelling, the jaundice, the confusion — all from an infection they know could be cured with a short course of treatment with a pill, if only he or she wasn’t incarcerated. (Florko, 12/15)

The final years of Carl Hoffer’s life were, in his words, “living hell.” His legs were so swollen they’d crack and leak white fluid. When he was hospitalized in August 2016, hospital staff used a needle to drain 7 liters of fluid from his abdomen. By the end, he could only move with the help of a wheelchair, and he’d often have accidents because he lacked the energy to get to the bathroom. (Florko, 12/15)

When he took on the state department of corrections, Phil Turney didn’t have a computer, let alone internet access. For two weeks, hunched around bankers boxes in the Idaho State Correctional Center’s multipurpose room, he toiled on his Smith Corona Wordsmith 200 typewriter, lifting legalese from a copy of the Prisoner’s Self-Help Litigation Manual and an earlier lawsuit in Minnesota. (Florko, 12/15)

For the prisoners who receive it, hepatitis C treatment is more than a cure. It offers a second chance, an opportunity to live long enough to get out of prison and become a productive member of the community. (Florko, 12/15)

State prison systems say they can’t afford to cure everyone with hepatitis C. The drug, even after a dramatic price drop, is still expensive. But several states have recently figured out how to make the math work. (Florko, 12/15)