Americans have access to treatment that works for Hepatitis C. Harvoni (ledipasvir/sofosbuvir) is a drug that, by inhibiting Hep C's RNA polymerase, prevents viral replication and halts the progression of the disease. Though this might be the case, many in rural America are unable to get this treatment, for the simple reason that it costs too much.
List prices for typical courses of the drug approach $100,000, a figure far out of reach for very many people. In fiscal year 2016, just 900 courses of the treatment consumed 5% of the State of Kentucky's pharmacy budget. This issue is compounded by the fact that the state is responsible for the medical fees of a great many Hep C sufferers, largely the result of Medicaid expansion. The opioid epidemic in much of rural America further contributes to this, as the use of unclean needles increases the opportunity for infectious disease transmission.
In these contexts, doctors and their practices focus on those aspects of care which are preventive, and try to emphasize behavioral changes in order to compensate for financial limitations that they and their patients may face.