Tag Archives: HIV

The State of Hepatitis C Coverage in America – Part 2: Medicaid

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 our final HEAL Blog post of 2018, we will be continuing from last week our analysis of Hepatitis C (HCV) coverage in the United States. While this was originally designed to be Part 2 of a three-part series, the decision was made to cut this month short by whittling that down to just two posts for the month of December.  As such, this final HEAL Blog will focus on the state of Medicaid coverage for HCV Direct Acting Antivirals (DAAs). Read Part 1, The State of Hepatitis C Coverage in America – Part 1: ADAP.

HIV/HCV Co-Infection Watch

HIV/HCV Co-Infection Watch

At the time of our inaugural report in January 2015, only 38 state Medicaid programs offered coverage for HCV DAAs. Even then, access to these treatments was severely limited by numerous onerous Prior Authorization pre-requisites, primarily those which required patients to suffer moderate-to-extreme liver decomposition and scarring – scores of F3 or F4 – before even being considered for treatment approval. Other pre-requisites include(d) sobriety requirements, drug use prohibitions, enrollment in recovery treatment programs, and numerous appeals.

In addition to these pre-requisites, both the states that ostensibly offered coverage and those that did not openly argued that made no bones about restricting or refusing coverage based on cost. So overt was their argument and pervasive the problem that the Centers for Medicare & Medicaid Services (CMS) issued a guidance letter to every state Medicaid program specifically stating that cost considerations “…should not result in the denial of access to effective, clinically appropriate, and medically necessary treatments using DAA drugs for beneficiaries with chronic HCV infections” (Center for Medicaid and CHIP Services, 2015).

With the CMS guidance was announced in November 2015, by August 2016, every state Medicaid program had expanded their coverage to include HCV DAAs. Since August 2016, every state has continued to offer coverage…again, ostensibly. Over time, several states have either reduced or eliminated the F-score requirements for treatment consideration, as well as removing other pre-requisites, the most recent of which was Oregon (this has not been officially announced, yet, so the citation is forthcoming).

As we have covered numerous times since Mavyret’s (AbbVie) August 2017 debut (including in last week’s HEAL Blog), the introduction of the drug at a remarkably lower Wholesale Acquisition Cost relative to other available DAAs allowed many programs to begin reducing or eliminating restrictions altogether. And, again, looking forward to the January 2019 release of Gilead’s authorized generic versions of their breakthrough drugs, Harvoni and Epclusa, the cost of HCV treatment continues to decline in part because of innovation, but mostly, because of AbbVie’s 2017 salvo with the lowest priced DAA on the market.

There are, however, newer DAAs in the pipeline. 2018 was the first year since 2013 in which a new HCV DAA was not released into the U.S. market. With prices demonstrably lower than the initially unconscionably high prices in 2013, it is unclear whether pharmaceutical companies will stay in the HCV game – Janssen, makers of the now-discontinued Olysio, the once-companion drug to Gilead’s Sovaldi – bowed out of game at the end of 2017, pulling Olysio from the shelves in May of this year. Companies that once assumed that their HCV drugs would enter into a highly competitive, high-priced market are coming up against incredibly popular and effective drugs that cost roughly 1/3 of the original DAAs. That difference in entry price does not bode well for newcomers or new drugs hoping to gain a foothold in the market.

The Community Access National Network will continue to monitor the state of HCV coverage in the U.S. Until next year, we wish you and yours the Happiest of Holidays and an even Happier New Year.

References:

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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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The State of Hepatitis C Coverage in America – Part 1: ADAP

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 month of December is filled with various holidays, parties, and celebrations. As such, we, here at the Community Access National Network, do everyone the favor of not releasing an 80+-page report to allow everyone the opportunity to take a break from poring over state-by-state treatment coverage charts, sifting through maps, and drinking in the latest news. Instead, we encourage you to pour yourself an eggnog, sift some ground nutmeg on top, and drink in some good cheer. In lieu of this month’s HIV/HCV Co-Infection Watch Report, we are doing a three-part HEAL Blog covering what has been a year of changes for the better, often despite the world around us.

HIV/HCV Co-Infection Watch

HIV/HCV Co-Infection Watch

In January 2018, we reported that there were 37 states (including the District of Columbia and Puerto Rico) that had expanded their AIDS Drug Assistance Programs (ADAPs) to include coverage for Hepatitis C (HCV) Direct Acting Antivirals (DAAs). To put this in perspective, in our inaugural edition in January 2015, there were only seven states (CA, CO, HI, IA, MA, MN, & NJ) that offered coverage for these drugs. Three years later, and 30 additional states have expanded coverage? That is a sea change of epic proportions.

In November 2018, we reported that there are 39 states (including the District of Columbia and Puerto Rico) that have expanded their ADAP programs to cover HCV DAAs. By comparison, in November 2015, there were 14 states that offered coverage, which, for that year, doubled the number of states covering DAAs. At the time, that was fantastically encouraging.

This trend of expanding coverage continued throughout the following years, and while these gains are impressive – particularly the fact that Mississippi expanded coverage – there is still work to be done. Including the U.S. Territories, there are still 17 ADAP programs (AK, CT, ID, IN, KS, KY, MT, NV, OH, SC, UT, VT, WY, Federated States of Micronesia, Guam, Palau, and the U.S. Virgin Islands) that offer no coverage or cover only Basic HCV treatment regimens (i.e. – Pegylated-Interferon and Ribavirin – treatment regimens that are no longer the standard of care for many years now).

Our colleagues over at the National Alliance of State and Territorial AIDS Directors (NASTAD) have done amazing work over the years to convince ADAP programs to expand their coverage, and Amanda Bowes, a Manager on NASTAD’s Health Care Access Team, presented an excellent set of reasons why ADAP programs choose to offer coverage (which can be found here – http://www.tiicann.org/urls/CANN-PPT-2-Bowes.pptx.

So, what will get these states and territories over the finish line? It is likely going to take an even more severe reduction in the cost of medications. With the impending release of Gilead’s authorized generic versions of Harvoni and Epclusa in January 2019 – the Wholesale Acquisition Cost (WAC) of which will be just $24,000 for twelve weeks of treatment (Hee Han, 2018) – we can hope that more states will decide that they can afford to expand coverage.

Of particular concern are Alaska, Indiana, Kentucky, and Ohio, three states that have been hit considerably hard by dual opioid and HCV epidemics in the past few years (as well as increases in HIV transmission related to Injection Drug Use among opioid and heroin abusers). With many of the newly infected HCV patients already being positive for or simultaneously contracting HIV andthe high burden of opioid and heroin abuse on the poor, it is likely that many of these patients will be eligible for their respective states’ ADAP programs. Coverage for HCV DAAs in these states is critical to ensuring that further costs associated with failing to treat and cure HCV are not shifted onto ADAPs.

As far as the territories are concerned, expansion of their respective ADAP programs to cover HCV DAAs is anybody’s guess. Every article we read about healthcare coverage in the U.S. territories indicates that they are essentially crumbling as a result of a fundamental failure of Congress to adequately fund territorial healthcare programs, including those that provide coverage of HIV or for the poor. The U.S. has long abdicated its responsibility to support these territories, and that is unlikely to change. Worse, still, despite having Congressional representation, these territories have little say in how the U.S. government treats them. If the Trump Administration’s response to Hurricane Maria’s total devastation of Puerto Rico is any indication, it is unlikely that they even know that the other territories exist, much less will they lift a finger to provide any resources to them.

All in all, 2019 may be the year that gets all the remaining states, at least, over the HCV DAA coverage hurdle.

References

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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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AbbVie Launches Website to Improve Awareness of Hepatitis C

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

At this year American Association for the Study of Liver Diseases conference, The Liver Meeting 2018, AbbVie – makers of Viekira Pak, Technivie, Viekira XR, and Mavyret – announced the launch of MappingHepC, an interactive online resource “…committed to improving the awareness of Chronic Hep C epidemiology in the United States” (AbbVie, 2018). This resource is intended to help fill the gap left by inadequate Hepatitis C (HCV) reporting at the local, state, and Federal levels by “…compiling and analyzing data from two large national laboratory companies representing the majority of U.S. patients screened for HCV antibody and/or tested for HCV RNA from 2013-2016” (AbbVie), and is updating soon to include data from 2017.

This tool is an excellent resource of advocates and people within state and Federal governments to visualize various aspects of the HCV epidemic, including the prevalence of antibody screening, HCV RNA-positive test results, age demographics, rates of infection, and HIV co-infection. The latter is incredibly exciting as few states have actively sought to combine datasets from HIV databases and HCV databases within their own Departments of Epidemiology to track HIV/HCV co-infection.

MappingHepC

Photo Source: MappingHepC

The mapping tool is relatively easy to use, with a variety of options that allow for the comparison of data between any two states by clicking on the state. Selecting a state will bring up a floating box that shows a chart, graph, or data point for that state (e.g. – the overall number of HCV RNA+ test results in 2016). This user-friendly design allows for concise data point retrieval – something that is highly sought in the advocacy world, because, let us be honest: whom amongst us really wants to read a detailed report, aside from the data geeks (n.b. – I am a data geek)? If advocates do not want to parse these data-heavy reports, without fail, state and local legislators and executive office holders have even less time or patience with them.

One of the most useful tools for treatment advocacy is the number of people who have initiative treatment. For example, despite West Virginia having the highest rate of infection in the nation, a mere 580 patients have actuallyinitiated treatment. According to the HCV RNA+ map, 4,229 people were HCV-positive in 2016, meaning that 13.71% of patients have been treated for their HCV infection. Compared to Massachusetts – the second-highest rate in the U.S. – where out of 13,783 HCV-positive patients, 2,796 patients initiated treatment (20.28%). These kinds of data are invaluable to patients and advocates fighting to expand access to treatment.

You can access this new site (and its data) by registering on the site: https://mappinghepc.com/.

The registration is quick and painless, and you canopt out of receiving AbbVie E-mail updates.

References:

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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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HIV Patients Co-Infected With HCV Face Higher Mortality Rates

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

A ten-year follow-up study has found that people living with HIV who are co-infected with Hepatitis C (HCV) face an increased risk of mortality by 4.3%, even when receiving treatment for HIV (Bender, 2018). The same study found that treatment with HCV Direct-Acting Antivirals (DAAs) resulted in a lower risk of mortality than those whose HCV went untreated, but that the harm caused by HCV still resulted in increased risk.

'Sensational' Hep C Response Rates in HIV Coinfection Trial

Photo Source: medscape.com

One of the primary consequences of untreated HCV infections is damage to the liver – damage that is no immediately repair itself once the virus is successfully treated. Liver fibrosis – scarring of the liver that prevents the organ from properly functioning – is not healed by HCV treatment, and depending upon the severity of the scarring, the liver may never completely regenerate. Those whose livers are cirrhotic – those with late-stage liver scarring – will likely never fully recover optimum liver function and may become dependent upon other prescription medications and dietary restrictions to aid in liver functions such detoxifying substances in the body, purifying blood, and making vital nutrients (Welch, 2017).

This issue is one that receives far less attention than it deserves and is part of why there is so much opposition against including Fibrosis Scoring in treatment determinations. While it may seem financially prudent in the short-term to limit treatment of HCV to those who are “sick enough” to be treated, the long-term negative health impacts of liver scarring are far costlier in the long-term. For those living with HIV, liver function is of critical concern as that is where most HIV medications are metabolized. If liver function is impaired, the drugs may not properly metabolize, making the treatment of HIV less effective.

References:

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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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AbbVie’s Mavyret Found Safe and Effective in HIV/HCV Co-Infected Patients

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 analysis of two Phase 3 trials evaluating the safety and efficacy of Mavyret (glecaprevir/pibrentasvir) in patients co-infected with Hepatitis C (HCV) and the HIV-1 virus (the most common form of HIV in the United States) has found that the drug is highly effective and safe for use in treatment (van Paridon, 2018). Using a 12-week regimen to treat patients’ HCV resulted in an overall 98% Sustained Virologic Response (SVR – “cure”) in individuals with or without cirrhosis across genotypes 1-5.

Mavyret

Photo Source: Hep Magazine

A total of 152 patients without cirrhosis received an 8-week regimen, while 16 with cirrhosis received the 12-week regimen. Overall, the SVR across all patients was 98% with no relapses in any HIV/HCV co-infected patients with or without cirrhosis. Those patients without cirrhosis who received 8 weeks of Mavyret resulted in an SVR at 12-weeks post-treatment of 99.3%.

Treatment in HIV/HCV-co-infected patients has been tricky from the beginning in no small part because only Sovaldi (Gilead) served as a useable treatment for patients with HIV, because it had the fewest counterindications with the most commonly prescribed HIV drugs. According to an HIV/HCV drug interaction report prepared this month from HEP Drug Interactions – which can be accessed at the following address – which can be downloaded here – most of the HCV Direct-Acting Antivirals (DAAs) have no negative interactions with the individual component drugs of most HIV regimens. Most of the combination drugs – the single-pill regimens most commonly used to treat HIV for the last decade – do have some counterindication with the DAAs…except for Sovaldi (sofosbuvir). Gilead’s other sofosbuvir combinations – Harvoni, Epclusa, and Vosevi – seem to have a greater chance at interacting negatively.

Zepatier (Merck) is a prime example of the aforementioned prescribing circumstance: it works well with individual drug components, but with only one HIV combination drug – Biktarvy (Gilead). Biktarvy is Gilead’s newest HIV regimen and is not yet widely prescribed, though it is recommended as one of the initial regimens for most people with HIV (AIDSinfo, 2018). Zepatier, itself, is only good in treating HCV Genotypes 1 and 4, while Epclusa and Mavyret are pangenotypic (meaning they can be used to treat Genotypes 1-6).

At any rate, HIV patients who are co-infected with HCV are gaining more treatment options as newer drugs are released, which is always a good thing; and, as more regimens emerge, perhaps there will be fewer interactions in the future .

References:

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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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3rd Annual National Monitoring Report on HIV/HCV Co-Infection Recap

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 Community Access National Network (CANN) hosted its 3rdAnnual National Monitoring Report on HIV/HCV Co-Infection on Wednesday, September 19th in Washington, DC, at PhRMA Headquarters. Presenters included Marcus  J. Hopkins (the author), Amanda Bowes (National Alliance of State and Territorial AIDS Directors – NASTAD), Jack Rollins (National Association of Medicaid Directors), and Ayesha Azam (Patient Access Network – PAN – Foundation).

HIV/HCV Co-Infection Watch

HIV/HCV Co-Infection Watch

I presented on the progress that’s been made in expanding access to Hepatitis C (HCV) Direct-Acting Antivirals (DAAs) in state Ryan White AIDS Drug Assistance Programs (ADAPs), Medicaid programs, and the Veterans Administration. In addition, I discussed some of the issues facing Harm Reduction measures (e.g. – Syringe Services Programs, Doctor Shopping laws, Prescriber Education requirements, et cetera), as well as CANN’s foray into Correctional Healthcare.

One key finding is that, as of September 2018, 39 state ADAP programs (most recently, Mississippi) have expanded their formularies to include coverage for HCV DAAs. By comparison, when the HIV/HCV Co-Infection Watch (CANN’s monthly report) began in January 2015, only 7 states offered expanded coverage. In addition, on the correctional healthcare front, there are currently at least 16 HCV-related lawsuits active in 14 states.

You can find my presentation at the following link:

Amanda Bowes, a Manager on NASTAD’s Health Care Access Team, presented on NASTAD’s work with Ryan White programs to expand access to treatment, as well as previewing a forthcoming PDF and web-based consultation tool – “Strategies to Increase Access to Hepatitis C (HCV) Treatment within ADAPs: Provider Decision Tree”– for providers to consult when determining how their patients living with HCV can pay for treatment.

In addition to this fantastic resource, Amanda also presented statistics about HIV/HCV Co-Infection within Ryan White programs. In calendar year 2016, over 1,000 (2%) across 15 ADAPs were reported as being co-infected with HCV at some point during the year. Of those, 336 (32%) of these clients received treatment for their HCV, and of those who were treated, 160 (48%) were reported as cured.

You can find Amanda’s presentation at the following link:

Jack Rollins, Senior Policy Analyst with the National Association of Medicaid Directors, presented on some of the opportunities to lower the costs of prescription drugs within state Medicaid programs. One of the most popular methods of controlling prescription in European markets is through the use Value-Based Purchasing (VBP), a concept that the U.S. has been loath to adopt in our traditional Fee-For-Service healthcare market.

The general idea behind “Value-Based Purchasing” (at least in nations with universal healthcare) is that purchasers – the buyer of the drugs prior to distributing them to patients – pay for drugs only when they prove “effective.” As that relates to HCV, the payor would only pay for the cost of the DAA if the patient achieves Sustained Virologic Response (SVR) – if the patient is cured of HCV.

VBP, as it’s currently being discussed in the U.S., looks much different. Currently, Oklahoma is the only state whose Medicaid program has an approved VBP, but the details of that are largely unavailable to the public due to existing trade secrets laws – a consistent sticking point with healthcare advocates that allows pharmaceutical companies and payors to “hide” the actual cost of medications.

Jack also mentioned two more states, Louisiana and Massachusetts, the latter of which recently had their VBP proposal denied by the Centers for Medicare and Medicaid Services (CMS). Massachusetts’s proposal was proposed to be limited in scope, proposing limited coverage for certain therapeutic drug classes with a robust exceptions process and would be tied to coverage decisions made by a Pharmacy Benefits Manager (PBM) and/or state employee benefits. Although this proposal was denied by CMS, several other states are interested in this idea.

Louisiana is looking at VBP policies specifically targeted at HCV DAA drugs, terming it the “Netflix for HCV.” Their idea would pool Medicaid and state Corrections populations under a model that would pay a flat amount to a drug manufacturer (say, Gilead) in exchange for unlimited access to their drug (say, Gilead’s Epclusa). Essentially, Louisiana would play a flat fee and be able to prescribe as much (or as little) of the drug as needed to treat patients and inmates with HCV.

You can find Jack’s presentation at the following link:

Ayesha Azam, Senior Director of Medical Affairs at the PAN Foundation, presented on the important of Co-Pay Assistance in underinsured populations. In defining who is considered “underinsured,” PAN goes by the following descriptors:

  • Individuals who spend more than 10% of their annual income on out-of-pocket medical expenses
  • Individuals who spend more than 5% of their annual income on deductibles
  • Individuals whose income is less than 200% of the Federal Poverty Level and medical expenses are greater than 5% of annual income
  • Seniors who do not have funds or who fall into the “donut hole” (where they have outspent their annual benefit, but have not reached the Medicare catastrophic coverage level)

So, using those descriptions, I’ll present my own information:

My health insurance through Highmark West Virginia BlueCross/BlueShield has a deductible of $4,000, which for me is around 12% of my annual income. My Out-of-Pocket Maximum is $5,000, around 15% of my annual income. With that in mind, let’s look at my Out-of-Pocket costs for the first quarter of 2018:

Doctor Visit Co-Pays (01/18 – 03/18): $246.34

Blood Work (single visit on 02/06/18): $1,785.00

HIV Meds (01/18 – 03/18): $768.00

Endoscopy (02/28/18): $278.68

Anesthesia (02/28/18): $440.50

TOTAL: $3,518.02

Add on a couple more months of the medications, and another volley of blood work in June, and I’ve hit both my deductible AND my out-of-pocket maximum before I’ve ever reached half-way through the year.

Using PAN’s definitions, I am critically underinsured; what’s worse is that the vast majority of plans made available through West Virginia’s health insurance marketplace are shifting further towards high deductible plans that tack on co-insurance after the deductible has been met (mine is 10% co-insurance), and I’m looking at spending nearly 1/3 of my annual income justfor my healthcare.

Without the West Virginia Ryan White Program, I would likely be so far underwater with medical bills (which I am), that I couldn’t even see to swim to the surface. Worse, still, is that, for HCV patients, there is noRyan White-type program to provide them with that level of financial assistance, leaving them to essentially fend for themselves.

This is where organizations like the PAN Foundation step in with Patient Assistance Programs (PAPs). In order to qualify for assistance with PAN, a client must be underinsured and make below 400%-500% (depending upon the fund-specific guidelines) of the Federal Poverty Level (FPL). PAN receives specific funding streams for individual conditions (e.g. – HIV, HCV, diabetes, arthritis, et cetera) and assist with the out-of-pocket costs associated with treatment. They will assist with Co-Pays, Travel to and from doctor appointments, and Insurance Premium payments.

The downside is that the demand for this assistance far outstrips the supply, and because each condition/disease has a specific funding stream, each fund has its own number of clients that can be helped before funds are exhausted. With most HCV drugs be shunted into Specialty Tiers, co-pays for each fill can be $250+ depending upon the insurance plan. To be clear – one member of the PAN Foundation stated, recently, that research indicates any co-pay over $50 to be “unreasonable.” Using that analysis, a single visit to my HIV doctor will set me back $60+, depending upon whether or not I’m assessed a clinic fee on top of my specialist co-pay.

This is where PAN Foundation (and other charitable assistance programs) are vital. Moreover, the vast majority of patients in the U.S. – already a low-healthcare-literacy nation – have no idea that these resources exist, which is a mixed blessing, for PAN: fewer patients knowing about the program means that funds will not be so quickly exhausted; the other side of that coin is that fewer patients will receive the critical financial assistance they need.

You can find Ayesha’s presentation at the following link:

 

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3rd Annual National Monitoring Report on HIV/HCV Co-Infection

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 Community Access National Network (CANN) will be hosting its 3rdAnnual National Monitoring Report on HIV/HCV Co-Infection on Wednesday, September 19th, beginning at 2:00 p.m. EST. This annual report provides valuable information on the state of Hepatitis C (HCV) treatment coverage, harm reduction measures to prevent transmission of HIV and HCV, and, new to this year, a brief focus on HIV and HCV testing and treatment for individuals currently incarcerated and post-incarceration.

Returning this year are yours truly (as the Project Director for the HIV/HCV Co-Infection Watch and Medicaid Watch), and Amanda Bowes, Manager on the National Alliance for State and Territorial AIDS Directors’ (NASTAD) Health Care Access Team. New presenters for 2018 include Ayesha Azam, Senior Director of Medical Affairs at the Patient Access Network (PAN) Foundation, and Jack Rollins, Senior Policy Analyst at the National Association of Medicaid Directors.

At last year’s National Monitoring Report, I focused on the increase in coverage options for both the Ryan White and Medicaid programs, showing how treatment options have expanded across the country since 2015 (when the HIV/HCV Co-Infection Watch began). Mrs. Bowes provided more detailed information available about coverage, as well as NASTAD’s efforts to expand coverage for Hepatitis C (HCV) Direct-Acting Antivirals (DAAs) within the nation’s AIDS Drug Assistance Programs (ADAPs).

This year’s event is sponsored by the ADAP Advocacy Association, Gilead Sciences, Merck, Quest Diagnostics, Walgreens, and the Pharmaceutical Research and Manufacturers of America (PhRMA).

The 3rdAnnual National Monitoring Report on HIV/HCV Co-Infection can be attended either in person at PhRMA Headquarters in Washington, DC, or remotely for non-DC residents. Registration is free and can be done online. While registration is free, there is limited seating for those attending in person and advanced registration is required to attend.

Learn more at http://www.tiicann.org/events.html#091918cr.

3rd Annual National Monitoring Report on HIV/HCV Co-Infection

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