Veterans Affairs Department Provides Reliable Proving Ground for HCV Treatment

HEAL Blog is the recipient of the ADAP Advocacy Association’s 2015-2016 ADAP Social Media Campaign of the Year Award
By: Marcus J. Hopkins, Blogger

The Veterans Health Administration (V.A.) is one of the most frequently and vocally derided health systems in America. Since its inception in 1930, the V.A. has been plagued by scandal, fraud, malpractice, and quality of care issues. There has been no single decade since 1930 when the V.A. hasn’t faced some sort of scandal, whether it be massive oversights in patient care, exorbitant wait times just to be seen, squalid facilities, or infection outbreaks. One Veteran said to me, during an exchange, “The V.A. can’t get good doctors in there, because nobody wants to be associated with the V.A.” Realistically, the V.A. has earned its poor reputation through decades of mismanagement, underfunding, understaffing, and inconvenient locations. Furthermore, every President since Franklin D. Roosevelt has promised to fix, once and for all, the V.A. health system. None have managed to do so, in whole.

Logo: U.S. Department of Veterans Affairs

Source: U.S. Department of Veterans Affairs

But, it’s not all bad. Improvements, though incremental and rarely immediate, have been made, and there are areas where the V.A. performs brilliantly. Perhaps the best example of this is how the V.A. has dealt with Hepatitis C (HCV) within Veteran populations.

In March of 2016, the V.A. announced that it would be expanding coverage for HCV treatment using Direct-Acting Antivirals (DAAs) to all Veterans in its health system who have the virus regardless of their disease stage (Kime, 2016). Since that time, the V.A. has proven to be the most successful public or private health system in the U.S. for screening, testing, treating, and curing HCV. More importantly, they achieve this not by limiting care to the sickest, but by opening access to the cure for HCV to all members.

As of June 2018, 83.5% of the V.A. Birth Cohort (those born between 1945-1965) have been screened and received HCV testing (U.S. Department of Veterans Affairs, 2018). Since 2014, the V.A. has treated 110,220 (through June 2018), and an average of 323 Veterans are starting treatment every week. The cure rates with all oral DAA therapies is 95%. These statistics are phenomenal, and if they were to be replicated in every healthcare setting, we could likely beat the World Health Organization’s 2030 target for HCV elimination a year or so early. We likely won’treplicate the V.A.’s success in other programs, but that’s a whole other kettle of fish.

So, what does all of this success mean for everyone else? Well, because of the nature of the V.A., all of the data collected are an excellent source of…well, data for other researchers to use for the purposes of making retrospective analyses to assess the risks and benefits of modern HCV therapies (May, 2018). Essentially, because the V.A. has provided treatment using every HCV DAA available, we have a broad base of knowledge to do comparative analyses of efficacy between the various DAAs and across various age, race, and health demographics.

While the V.A. does have serious problems to correct, they are doing a lot of things “right.” HCV – the most fatal disease in the U.S. – just happens to be one of those.

References:

  • Unites States Department of Veterans Affairs. (2018, August). Hepatitis C Virus (HCV) VA IS A NATIONAL LEADER IN HEPATITIS C TESTING, CARE, AND TREATMENT. Washington, DC: United States Department of Veterans Affairs: Office of Public Affairs: Media Relations. Retrieved from: https://www.hepatitis.va.gov/pdf/VA-HCV-Fact-Sheet.pdf

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Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.

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