Tag Archives: Direct Acting Agents

Lower-Priced HCV Drugs Haven’t Improved Treatment Approvals

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 Free Market will work! Competition in the Hepatitis C drug market will force prices down, and everything will be okay!”

This has been the mantra of pharmaceutical companies and market watchers since the 2013 introduction of the highly-effective, but extremely expensive Direct-Acting Agents (DAAs) to treat and cure Hepatitis C (HCV). And, in point of fact, prices for treatment have decreased significantly since Sovaldi hit the market with a Wholesale Acquisition Cost (WAC) of $84,000 for twelve weeks of treatment. The latest (and cheapest) drug to hit the market – AbbVie’s Mavyret – sells for “just” $39,600 for twelve weeks of treatment. But, that twelve-week treatment period is for the most aggressive HCV cases; the recommended treatment for most patients is eight weeks, for which Mavyret goes for $26,400.

Curiously enough, however, healthcare payors have done their damnedest to not cover these drugs for patients. A study published in June of this year (2018), insurance companies deny coverage in 35.5% of cases (over 1/3 of the time); for patients with commercial insurance, the denial rates are even higher (Kaltwasser, 2018).

$100 bill with prescription medicine on it

Photo Source: Consumer Reports

As Kaltwasser points out in his MD Magazine article, previous studies published in 2016 indicated that the approval rate was much higher, and that Medicaid denial rates were higher. While Medicaid approval rates have improved (after a 2015 letter from the Centers for Medicare and Medicaid Services to state Medicaid directors informing that denials based on the cost of treatment violated Federal law), that does little to help the 56% of Americans with commercial insurance.

When patients are denied coverage, there are options – Patient Assistance Programs (PAPs) are designed to aid patients who are either underinsured or whose insurance plans deny coverage of certain drugs. Manufacturer-provided PAPs, like those offered by Gilead Sciences and AbbVie, pay for most (if not all) of the out-of-pocket expenses for purchasing the drug, whereas private PAPs, such as the PAN Foundation, provide assistance for patients whose insurance company agrees to pay for treatment and patients need assistance with the out-of-pocket costs.

Another, more common route is the appeals process, which can take weeks, if not months, and requires a lot of extra groundwork from all parties. Some patients have gone through numerous rounds of appeals and denials, just to get an approval. This process is exhausting, and frankly, it’s not good for the health of patients who go through unnecessary stress just to get the treatment they need (and pay).

Worse, still, is that, while the cost to payors has decreased along with WAC prices, the price to consumers has not.  In fact, for many patients, those costs have increased as insurers place HCV DAA drugs in “Specialty Tiers” or the highest payment tiers in their policy, meaning that patients will pay $100+ out-of-pocket for co-pays.

HIV medications – the newer ones, at least – often fall into this “Specialty Tier” as well. My monthly co-pay for my HIV medications, for example, sets me back $250/month on top of the $285+ monthly premium, for a total of over $500/month. Were these costs not covered by West Virginia’s Ryan White program, nearly ¼ of my monthly income would be dedicated solely to treating my HIV, and that leaves out the up to $500 that each of my biannual doctor visits cost me, including the $75 co-pay, plus the cost of the bloodwork, any X-Rays, or procedures I need done.

HCV patients get to go through all that, and worse, without the benefit of a Ryan White-style program that helps to cover the cost of treatment. And the cost of treatment is higher for HCV on an annual basis.

I know I’ve beaten this drum, before, but the fact is this: until such time as the U.S. joins the rest of the modern world and begins offering Universal Healthcare, patients are going to be the ones getting screwed at every turn, in addition to being nickeled and dimed for every cost a provider can cobble together every time they visit a doctor. Insurance company, pharmaceutical company, and for-profit hospital profits will soar, while patients will continue to struggle to afford even poor-quality healthcare that would be unacceptable in every other First World nation, never mind quality, comprehensive healthcare.

In the meantime, patients living with chronic illnesses are just going to have to suffer through denials, appeals, and ever-mounting medical debt that will leave us scraping by from month to month, just to make ends meet. But, hey! At least we won’t have to suffer the indignities of “Socialized Medicine,” where Conservatives insist that, as David Sedaris once put it, “…patients [will] lie dirty cots waiting for aspirin to be invented.”

Lucky. Us.

References:

__________

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.

Advertisements

Leave a comment

Filed under Uncategorized

Three States Expand Access to Hepatitis C 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

In the past two months, three states – California, New Jersey (Hester, 2018), and Rhode Island (Miller, 2018) – have moved or plan to move to drastically reduce the number of prerequisites to gain access to Direct-Acting Agents (DAAs)to treat and cure Hepatitis C (HCV). Here, at HEAL Blog, we have been advocating for such a change since our inception, though it would be hubristic to suggest that a single blog post could account for any change to state Medicaid policies.

As discussed in the previous blog linked above, California’s efforts to expand access likely relate to a couple of Class-Action lawsuits they’ve been facing over the past few years, both from Medicaid clients and incarcerated citizens. Rather than wait to end up paying exponentially more by way of settling or outright losing in court, the state wisely chose to expand access by providing more money through the budgeting process. This additional $176 million will allow the state to open treatment to more lower-income Medi-Cal recipients, as well as those incarcerated.

New Jersey has also broadened coverage for HCV DAAs to cover all Medicaid enrollees in the state once someone is diagnosed with the virus. This policy change was also facilitated by increased funding in the FY2019 budget to the tune of $10m. (Stainton, 2018).

New Jersey’s Medicaid program, however, is run a bit differently. Since 1995, the state’s Medicaid program has been administered by way of Managed Care Organizations (MCOs) – private companies who are contracted to provide and disburse benefits and payments to Medicaid recipients in exchange for a per member per month capitation payment. Currently, there are five private insurers who offer these services: Aetna, Amerigroup NJ, Horizon NJ Health, UnitedHealthcare Community Plan NJ, and WellCare. MCOs are designed to save state’s money by outsourcing the work to private companies for cheaper than the state itself would spend on salaries, pensions, and benefits to administer the program. Of the five MCOs in New Jersey, all but oneplan (Amerigroup NJ) provide drug coverage only for Mavyret (AbbVie), the newest pangenotpyic DAA drug on the market (which is conveniently also the cheapest). Amerigroup alone provides coverage to virtually every other DAA still on the market.

The problem with MCOs is that, because they are private companies providing this service, they are not always quick to adapt to new rules and regulations. There are several states which employ MCOs alongside traditional Fee-For-Service (FFS) Medicaid programs. The rub is that MCOs are required by law to provide the same coverage for clients as the FFS program, meaning that, if the FFS Program covers all available DAA drugs, the MCOs must also offer the same drug coverage. This is rarely the case, and few people, either from the state governments, or individuals who enroll in these plans, ever really push the point hard enough to ensure that MCOs are meeting this requirement. In the case of New Jersey, there is no FFS Medicaid programs; it’s entirely operated via MCOs, which essentially means that it will be difficult for New Jersey’s government to ensure that clients in all five MCOs are receiving access to this expanded treatment.

Finally, Rhode Island has also broadened coverage for HCV treatments. This was accomplished as a result of persistent lobbying by the Rhode Island Center for Justice, the Center for Health Law and Policy Innovation of Harvard Law School, and community activists and lawyers (Miller).

The ball got rolling on this change when a state resident receiving legal representation after being denied treatment by the state’s Medicaid program. The Center for Health Law and Policy Innovation has been tireless in its efforts to expand access to treatment of chronic illnesses both by government-funded programs, and by private insurers. Over the past three years, the Center has repeatedly stepped in on behalf of Medicaid recipients and privately insured individuals to use public pressure and threat of legal action to ensure that patients receive the coverage to which they are entitled, either by Federal law, or by state mandate. They have worked with several states to create HCV medication pilot programs that allow state AIDS Drug Assistance Programs (ADAPs) to offer coverage for HCV drugs that they might otherwise never receive.

All three of these states are moving in the right direction. Hopefully, we will see more forward momentum from other states in the coming months.

References:

__________

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.

Leave a comment

Filed under Uncategorized

Absolute Denial of HCV DAA Treatment Not Only Common, But Rising

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 high cost of curing Hepatitis C (HCV) with newer Direct-Acting Antiviral (DAA) drugs has been the fodder of many an article since their introduction into the commercial market in 2013 with Sovaldi (Gilead) and Olysio (Janssen). When Harvoni (Gilead) entered the market in 2014, its Wholesale Acquisition Cost (WAC) of $94,500 for 12 weeks of treatment, it was dubbed “The $1,000-a-Day Pill” by the media and a Congressional investigation was launched in the U.S. State Medicaid programs insisted that treating everyone with HCV on their rolls would not only obliterate their pharmacy budgets, but do so exponentially.

Gilead Sciences tried to do their part by offering a manufacturer Patient Assistance Program (PAP) that offered drastically reduced or free fills on these prescriptions if patients were denied coverage by Medicaid, Medicare, or their private insurer. That program was quickly inundated by patients whose payors instructed them to “…go and get it for free from Gilead.” By 2015, Gilead was forced to restrict the PAP to only the uninsured and those whose insurance denied coverage.

Now, new research published in Open Forum Infectious Diseases has found that, between 2014-2017, 52.4% patients with private insurance who were prescribed DAAs to treat their HCV infection were absolutely denied treatment (defined as “a lack of fill approval by the insurer”). In addition 34.5% of patients on Medicaid were denied, and a paltry 14.7% of patients with Medicare insurance were denied (Gowda, et al, 2018). These findings are compounded by similar research conducted regarding HCV treatment in correctional settings that found less than 1% of inmates infected with HCV in state correctional facilities were receiving treatment (Paukstis, 2018).

denied square red grunge stamp

Photo Source: emdlaw.com

This appalling record of absolute denials of treatment are a large part of why the U.S. has fallen behind comparable nations in achieving the elimination goals set forth by the World Health Organization in 2016, calling for the elimination of HCV as a public health crisis by the year 2030. Worse, these denials have come as the cost of treatment has dropped dramatically, from its high point with Harvoni, to its lowest point with AbbVie’s Mavyret, which has a WAC of $26,400 for 8 weeks of treatment ($39,600 for 12 weeks). Moreover, Mavyret sports comparable Sustained Virologic Response (SVR – “cure”) rates to Sovaldi, Harvoni, and Epclusa (Gilead). Worse still is that the WAC is largely a useless price point, as the vast majority of payors enter into pricing negotiations with the drug manufacturers and receive discounts and rebates that reduce that cost to a mere percentage of the WAC.

And, yet…

America’s healthcare problems are all solvable…in we are willing to go on the offensive against the corporate interests that we’ve allowed to run roughshod over our nation’s healthcare system since the late 1970s. We have allowed private insurers, drug manufacturers, and other private entities to turn healthcare away from being a profession designed to cure people – a system that we, as a nation, helped to flourish and turned into the best in the world in the mid-1900s – and into a for-profit industry whose main priorities revolve around further enriching the already rich.

We can combat diseases like HCV; hell, we managed to eradicate polio in the U.S. by 1979 with a vaccine that was created in 1953 and came into commercial use in 1955, with an oral vaccine following in 1961.

Jonas Salk, the creator of the first polio vaccine, once told Edward R. Murrow, when asked who owned the patent for the vaccine, “Well, the people, I would say. There is no patent. Could you patent the sun?”

Since that time, countless business writers and corporate shills have derided Salk’s statement, going so far as to call it “Communist propaganda.” And, yet, it is because of Salk’s vaccine that we managed to eradicate polio in much of the modernized world.

We need to get back to this way of thinking, as it relates to healthcare. It’s time to pull the profits out of healthcare, altogether, and if that means dismantling the private insurance market, then so be it.

References:

__________

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.

Leave a comment

Filed under Uncategorized

Hepatitis C in Native American Populations

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

In August 2017, HEAL Blog covered efforts by the Cherokee Nation to proactively combat Hepatitis C (HCV) within the tribe’s boundaries in Northeastern Oklahoma (Hopkins, 2017). The program, started three years ago, comprised several steps, including compulsory screening of all tribe members aged 20-69, expanding screening locations to include dental clinics, establishing a Syringe Services Program (SSP) within the tribe’s borders, and using Direct-Acting Antivirals (DAAs) to treat those infected with HCV. The tribe, itself, is absorbing the costs of treating its citizens (Juozapavicius, 2018).

Photo Source: HHS

Map of Cherokee Nation

According to the most recent report released by the Centers for Disease Control and Prevention (CDC), deaths related to HCV have been decreasing in every demographic since 2013, including in Native American (NA) populations. That said, NAs still had the highest rate of HCV-related death in 2016, with a rate of 10.75 (per 100,000), down from a staggering 12.95 in 2015 (CDC, 2018). These data indicate that, while the effort by the Cherokee Nation are certainly proving to be effective, there is still a lot of ground to cover.

As with other race demographics, the leading risk for HCV infection is Injection Drug Use (IDU). Doctor Jorge Mira, Director of Infectious Diseases for the Cherokee Nation, indicates in the Juozapavicius article that, over the past two years, he began hearing the word “heroin” more and more, every day. This trend of IDU is in line with other race demographics. The common factors across race demographics are high levels poverty and unemployment. In areas where these factors are present (particularly in rural settings), heroin use and IDU are almost a given.

The efforts to combat the disease within the Cherokee Nation need to be replicated at the state and Federal levels. The reality is that these problems are not going to go away, and in the areas where they’re most prevalent, they are going to get exponentially worse in the coming years. In the meantime, we can look to the Cherokee Nation for their leadership on the issue, and begin implementing them in small scale at the local level.

References:

__________

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.

Leave a comment

Filed under Uncategorized

Is it Time for a Rethink on Hepatitis C Care?

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

In the state of West Virginia, any Medicaid beneficiary who is diagnosed with Hepatitis C must personally or through their prescribing doctor consult with either an Infectious Disease specialist or a doctor whose specialty includes Hepatitis C (e.g. – a Hepatologist) in order to have their prescription for Hepatitis C (HCV) Direct-Acting Antivirals (DAAs) approved. In addition, the patient must have a Metavir fibrosis score of F2 or higher as a prerequisite, as well as abstain from illicit drug and alcohol use for a period of 3 months.

These additional barriers to treatment are not only time consuming, but potentially costly. The consultation requirement, alone, exponentially increases the amount of money Medicaid must reimburse just in order to fill a prescription that can now be obtained for potentially $10k per patient (this, according to hearsay, since actual prices paid are forbidden from being made public by existing Trade Secrets laws). Beyond that, even current screening practices tend to require patients to see a specialist, just to get screened for the disease. This is both problematic, and relatively easily remedied.

Barriers to seeing out health care. About 1 in 2 Americans admit they have put off needed health care and have avoided going to a doctor when necessary.

Photo Source: VeraQuest

With the introduction of HCV DAAs in 2013, HCV patients gained access to what was once thought improbable – a relatively easily tolerated “cure” with a high level of efficacy and considerably fewer and less serious side effects. Since that time, an additional nine HCV DAAs have been brought to the market, with newer drugs coming down the pike. The most recent release, AbbVie’s Mavyret, is a potential game changer, offering curative treatment in 8-to-12 weeks for roughly 1/3 to 1/2 the price of the most popular drugs on the market, while sharing essentially identical cure rates. In fact, Mavyret has become the Preferred Drug for several Medicaid Fee-for-Service and Managed Care Organization (MCO) plans since its approval in August of last year.

But, still, issues remain. In West Virginia, the rate of HCV more than doubled from 3.4 (per 100,000 persons) in 2015 (CDC, 2017) to a staggering 7.2 in 2016 (West Virginia Department of Health and Human Resources, 2018). While increased screening may account for this considerable increase, 68% of new Acute HCV infections listed Injection Drug Use (IDU) as the primary risk factor (WV DHHR, 2018), which indicates that increased screening of this community needs to be a priority.

Some of the ways that this can be accomplished is at the regulatory level – requiring screening of all adults in virtually every healthcare setting (e.g. – emergency rooms, primary care, community health centers, urgent care clinics, and correctional settings). In fact, in a simulation model, researchers from Boston Medical Center, Mass. General Hospital, and Stanford University found that this expanded screening protocol would increase life expectancy and quality of life, while also remaining cost effective (Legasse, 2018).

The strategy would also identify an estimated 250,000 more HCV cases than the current U.S. Centers for Disease Control & Prevention (CDC)-recommended strategy of focusing screening efforts on the Birth Cohort – individuals born between 1945-1965 (Green, 2018). This would have a projected benefit of increasing cure rates from 41% to 61%, while also reducing the risk of death from HCV-linked conditions by more than 20% compared to the current CDC guidelines (Toich, 2018).

It is clear that expanding screening to include all adults, rather than focusing efforts on the Birth Cohort and those whose doctors are aware of any other risk factors (because, let’s be honest – few people who inject drugs are open about that with most doctors, unless they’re there for an IDU-related condition or because of an overdose, at which point, it’s pretty obvious). Once we achieve THAT measure, we can move on to allowing Primary Care Physicians and Registered Nurses begin to administer and monitor HCV DAA therapy, because, it’s just not that difficult to do.

References:

__________

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.

Leave a comment

Filed under Uncategorized

U.S. Falling Behind in HCV Elimination Goals

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

Nine nations are on track to eliminate Hepatitis C (HCV) by 2030 – Australia, Egypt, France, Georgia, Germany, Iceland, Japan, the Netherlands, and Qatar. Notably absent from this list is the United States. The World Health Organization (WHO) set a target goal of 2030 for the elimination of HCV as a public health crisis in 2016. Despite this goal, only nine nations are on target to meeting that deadline.

World Health Organization logo

Part of what makes the elimination of HCV so difficult, particularly in the U.S., is the steps required to actively combat the disease: treating 7% of the HCV-infected population without restrictions; actively working on harm reduction issues (e.g. – Syringe Services Programs); actively screening patients. These three steps require making HCV a political priority at a time when other issues – foreign intervention, taxation, economic concerns, and the provision of healthcare as a right – dominate the political landscape.

In the U.S., each of these key steps that make elimination a possibility are hampered by a fundamental disagreement between warring political factions about the role of government in healthcare. The current administration occupying the Executive Branch has taken numerous steps – cutting funding, leaving funding levels flat, and cutting/underfunding staffing – that further complicate already difficult issues related to adequately combatting HCV in the U.S.

At the heart of each of these steps is the issue of funding. The high cost of HCV Direct Acting Agents (DAAs) – the current standard of care for curing HCV – has led almost every state-run healthcare program to restrict access by introducing Prior Authorization (PA) pre-requisites in order to even be considered for treatment. These PA requirements can include liver fibrosis scores (F-scores) above a certain level, that prescribing physicians either be or work in conjunction with hepatologists, gastroenterologists, or infectious disease specialists, abstinence from alcohol and/or recreational drugs for a predetermined period, and other restriction not placed upon patients needing treatment for other deadly diseases. The purpose behind these PA requirements are ostensibly to ensure that only patients who are likely to complete the relatively short regimens receive treatment, but in effect serve as cost saving measures to ensure that programs don’t have to pay for the drugs.

Harm reduction programs are equally contentious within the U.S., though Syringe Services Programs (SSPs) are gaining in popularity as a result of the prescription opioid and heroin crises sweeping our nation’s suburban and rural areas. Despite the increase in approvals for the establishment of SSPs in otherwise politically and socially conservative areas of the country, many states and Federal regulations place restrictions on how funds can be spent, meaning that syringes and other injection supplies may not be allowed to be purchased using taxpayer-funded monies.

Image promoting needle exchange for IDUs

Beyond that, local communities are beginning to experience a pushback against SSPs from residents who fear that the very presence of the programs in their neighborhoods, alone, leads to or has created a public health concern. Several counties in Indiana, where both HIV and HCV infection rates have seen increases due to Injection Drug Use (IDU), have voted to remove approval for SSPs and other Harm Reduction Clinic efforts in 2017 in no small part because of erroneous claims that the programs create hazardous waste and attract unwanted People Who Inject Drugs (PWIDs) into otherwise “drug free” communities. These fears have been stoked by elected officials (sheriffs, prosecutors, and/or legislators) who stalwartly refuse either to believe the research and evidence presented to them, or the real world results of the programs.

Screening for HCV in the U.S. is another costly endeavor, as Federal funds for state-level screening efforts fall far short of what is needed to adequately combat the spread of HCV. Moreover, there is currently no Federal requirement that certain populations be routinely screened. This leaves screening, tracking, and reporting guidelines up to the individual states, most of whom simply do not have the funds to engage in such a costly effort. Without adequate screening protocols in place on a national level, the U.S. cannot hope to meet elimination targets.

The U.S., for much of the 20th Century, led the world in the eradication of public health threats. This status has been erased, largely because of political efforts to reduce the role that government plays in healthcare compounded with the ever-increasing costs of healthcare. It is time for the U.S. to take a stand, reclaim its standing, and put behind us the burden of for-profit healthcare.

References:

__________

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.

Leave a comment

Filed under Uncategorized

2nd Annual HIV/HCV Monitoring Report Released

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

On September 21st, 2017, the Community Access National Network (CANN) hosted the 2nd Annual National Monitoring Report on HIV/HCV Co-Infection at the Pharmaceutical Research and Manufacturers of America (PhRMA) headquarters in Washington, D.C. Presentations were delivered by yours truly, and Amanda Bowes, Manager on the Health Care Access team for the National Alliance of State and Territorial AIDS Directors (NASTAD), both of whom focused on issues of coverage for Hepatitis C (HCV) Direct Acting Antivirals (DAAs) for the 59 AIDS Drug Assistance Programs (ADAPs) and Medicaid programs, as well as information about the U.S. Department of Veteran Affairs (V.A.) and Harm Reduction measures.

HIV/HCV Co-Infection Watch

HIV/HCV Co-Infection Watch

Key findings of my presentation indicate that, as of August 2017, 33 state ADAP programs offer coverage for DAAs on their ADAP formularies, an increase of six states from August 2016. Additionally, all 50 states and the District of Columbia have offered expanded coverage for DAA drugs since August 2016. In March 2016, the V.A. began offering treatment with DAAs to every eligible veteran. In terms of Harm Reduction, several states have authorized Syringe Services Programs (SSPs) in an effort to prevent the spread of HIV, Hepatitis B (HBV), and HCV since Congress ended the ban on Federal funding for Syringe Exchange Programs in January 2016.

One other key finding was that, in seven of the states with the ten highest rates of HCV infection, ADAP programs offer either no coverage for HCV drugs or offer coverage only for older, less easily tolerated treatments requiring the use of Pegylated-Interferon (PEG-INF). These states include (in order of highest HCV infection rates): WV, KY, IN, NM, AL, NC, and OH.

Key findings of Mrs. Bowes’ detailed presentation indicate that NASTAD has actively been attempting to increase HCV DAA coverage by ADAP programs in cooperation with the Health Resources and Services Administration (HRSA) while still maintaining fiscal solvency. This consultation, in June 2016, included ADAP and Viral Hepatitis (VH) program staff, Federal partners including the Centers for Medicare and Medicaid Services (CMS), U.S. Department of Health and Human Services (HHS), HRSA, and the U.S. Department of Veteran Affairs (V.A.), providers specializing in treatment for HIV/HCV co-infection, community partners, and NASTAD staff. The meeting was comprised of a panel of Federal representatives, a presentation on the best practices for ADAP HCV treatment utilization, and a discussion of the various barriers preventing ADAP programs from expanding coverage, clinical management of HIV/HCV co-infection, and policies and procedures for HCV treatment among People Living With HIV (PLWH).

Additionally, NASTAD gathering detailed information related to how ADAP programs covered the cost of HCV DAAs, finding that programs that offered Insurance Continuation (purchasing private insurance coverage for ADAP clients) and paid for the co-pays, rather than paying the full prescription cost, were able to save considerably over paying directly for the medications.

__________

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.

 

 

 

 

Leave a comment

Filed under Uncategorized