Elizabeth Carley v. Romeo Aranas

I. BACKGROUND

A. Factual Background 1. Hepatitis C Hepatitis C is a “blood borne pathogen transmitted primarily by way of percutaneous exposure to blood.” HCV can cause liver fibrosis—or scarring to the liver—which may “lead to cirrhosis of the liver, a liver disease that forestalls common liver function.” A common, non-invasive method used to measure the disease’s progression is the Aspartate Aminotransferase Platelet Ratio Index (“APRI”). A patient’s APRI score, along with clinical symptoms, are “reliable indicator[s] of liver fibrosis,” although not definitive.

CARLEY V. ARANAS

Over the past several years, the landscape of HCV treatment has changed dramatically. In 2013, the FDA began approving direct acting antivirals (“DAAs”) as a new treatment, which were shown to cure HCV in 95–99% of cases. Previous treatments had significant side effects and were much less effective. However, the new DAA treatments were often costly and were not recommended for all HCV patients until 2015. See, e.g., Atkins v. Parker, 972 F.3d 734, 736 (6th Cir. 2020) (“In 2015, the cost of a single course of treatment using direct-acting antivirals was between $80,000 and…