Hepatitis C is one of the most common causes of liver disease in the United States, and can be cured with a highly effective drug. But few Medicare and Medicaid beneficiaries with the disease are treated within a year of their diagnosis, according to new findings from the Centers for Disease Control and Prevention.
Hepatitis C is mainly a blood-borne disease, and can spread through contaminated needles among other infection routes, both in the community and in healthcare settings. It can remain asymptomatic and undetected and it can lead to weakness and liver failure.
U.S. long-term care residents are estimated to be at higher risk for these infections. Estimates peg infection rates in facilities between 1.4% to 11%.
Hepatitis C is treated using direct-acting antiviral (DAA) tablets that have a cure rate of over 95%. But in the new CDC study, which followed insured patients up to age 69, approximately one third of privately insured adults and one quarter of Medicaid and Medicare recipients began DAA treatment within 360 days of their diagnosis.
There were also disparities. Among persons receiving Medicaid, treatment with DAA was lower in those reporting Black or other races, and in those who lived in states with treatment restrictions, reported Carolyn Wester, MD, and colleagues.
Treatment, policy changes needed
To increase access to hepatitis C treatment with DAA, the authors contend that policies limiting patient eligibility based on fibrosis stage or sobriety be removed, that treatment through specialists be required and that there be no requirement for preauthorization.
“Universal hepatitis C screening coupled with simplified treatment protocols should be integrated into primary care and other settings serving persons with hepatitis C,” the authors wrote. They also recommended that the number of primary care providers treating the disease be expanded, “especially Medicaid providers serving populations disproportionately affected by hepatitis C.”
“Unrestricted access to timely DAA treatment is critical to reducing viral hepatitis–related mortality, disparities and transmission. Treatment saves lives, prevents transmission and is cost saving,” they concluded.
Full findings were published in the CDC’s Morbidity and Mortality Weekly Report.
