Tag Archives: Medicaid

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:

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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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California Plans to Allocate $176 Million to 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

The state of California has revised its 2018-2019 state budget to include $176 million to expand Hepatitis C (HCV) treatment to low-income citizens (Bartolone, 2018).

For low-income recipients of Medi-Cal (California’s version of Medicaid) and inmates in state prisons, access to the Direct-Acting Antivirals (DAAs) that cure HCV by allowing a patient to achieve Sustained Virologic Response – SVR – has been extremely limited. For recipients of Medi-Cal, there were several prior authorization requirements that served as barriers to treatment (Department of Health Care Services, 2015). For patients incarcerated in California state prisons, access has been so difficult that inmates have had to file a Class-Action lawsuit in an effort to force the state to provide the Constitutionally guaranteed access to treatment they should be receiving (Bayse, et al. v. California Department of Corrections and Rehabilitation, et al.).

Medi-Cal

Photo Source: Kaiser Health News

The newly allocated funds – $106m – will primarily go to the correctional system, as the rate of HCV infection is much higher in correctional settings than in the general population (Holzer, 2018). In speaking with colleagues at the National Viral Hepatitis Roundtable, the scuttlebutt around California is that this revision to increase HCV funding is a preemptive step to resolve the pending Class-Action suit against the state. The thinking seems to be that it will be cheaper to pony up the money to treat inmates, now, rather than to wind up paying a potentially much higher amount to accomplish the same goal, as well as potential damages awarded for failing to provide access to treatment.

While these funds are a fantastic development, history has shown that, even when the money is there, changing course is often difficult to implement with any immediacy. We’ve seen, before, that there will always be bugs in the system. Though Medi-Cal hasn’t yet moved to alter the existing prior authorization restrictions, it is highly anticipated that the agency will do so within the coming months (Bartolone). The $70m in additional funds designated to pay for treatment of approximately 2,090 patients. Let’s see if that comes to fruition.

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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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:

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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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Hepatitis C Death Rate High Among Uninsured and Medicaid Recipients

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

Researchers presenting at Digestive Disease Week found that, between 2000-2010, adult who were infected with Hepatitis C (HCV) were more likely to die if they were either uninsured, or recipients of Medicaid benefits (Basen, 2018). Being HCV-Positive correlated with higher mortality rates (10.4% compared to 3.1% for HCV-Negative patients).

The limitations of these data are several – (a.) the data are nearly a decade old; (b.) these HCV mortality rates are from an era where the only curative treatments for the disease had a treatment abandonment rate of between 40-80%, because the Pegylated-Interferon treatments were almost impossible to tolerate; (c.) an artifact of those older treatments was that the Centers for Disease Control and Prevention (CDC) were not proactive about pushing HCV testing beyond the Birth Cohort (1945-1965).

While these data are nearing ten-years-old, they do reveal some interesting patterns that HEAL Blog has been contending for some time: (1.) Medicaid recipients were more likely to be infected with HCV than those with insurance; (2.) HCV infection rates were highest among the uninsured; (3.) HCV-Positive Medicaid recipients had higher rates of extra-hepatic (illnesses other than those affecting the liver) comorbid conditions, such as diabetes, congestive heart failure, and stroke.

Outpatient Medicaid Office

Photo Source: VinNews.com

Essentially, much like HIV, although neither disease discriminates against any class, color, or education level, those who are poorer, less educated, and minorities are disproportionately impacted by these fatal diseases. More to the point, there is no single rightway to deal with these issues; none of these issues exist in isolation:

  • less education correlates with and contributes to poverty, as well as leaving people less able to understand health risks and how to deal with any diseases they contract;
  • people who are impoverished tend to have less access to comprehensive (or even basic) healthcare services, and if they are poorly educated, they are less likely to utilize healthcare services, because they often don’t recognize symptoms of disease;
  • people who are have less access to healthcare services are likelier to develop chronic illnesses that prevent them from working, thereby increasing their likelihood of remaining in poverty.

Because these problems are interconnected, dealing with just one aspect is an ineffective approach – we cannot just address access to healthcare, because we’re not also addressing how people will pay for healthcare and treatment, nor are we considering the impact that accessing healthcare can have for people who have to miss hourly-wage jobs in order to access said care, and thus lose money, only to have to spend more money.

And, honestly, I don’t know what the answers in today’s America are. In a perfect world, we would have Universal Healthcare paid for by tax dollars that would low- to no-cost out-of-pocket, as well as expanded and affordable public transportation, higher wages, rent control, and free college and university paid for by taxes (like most of the rest of the modernized world). But, we don’t have those things, and it’s not likely we’re going to get those things any time soon.

In the meantime, looking at these data are a great way for us to craft policies to address these issues, particularly as new HCV infections are trending younger and younger, and younger people are less likely to be insured. Food for thought.

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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Trump’s War on the Poor is a War Against Us

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 April 10th, current President, Donald J. Trump, fired the latest Republican salvo against the poor and social welfare programs by signing an executive order intended to force recipients of food assistance, Medicaid, and low-income housing subsidies to “get a job” or lose their benefits. A question that has yet to be answered is whether or not this edict will apply to recipients of Ryan White benefits, which provide low- or no-cost HIV medications, medical and dental treatment coverage, and other ancillary, yet vital services to an estimated 52% of people diagnosed with HIV in the United States (Health Resources and Services Administration, 2016). Those co-infected with Hepatitis C (HCV), whose cure requires treatment with some of the most expensive drugs on the market, are likely to be harmed, as well.

Make no mistake – this latest royal decr…executive order – unironically titled, “Reducing Poverty in America” – is specifically designed notto actuallypull people up out of poverty, but to force the “undeserving” off of the public dole. The order is directed at “any program that provides means-tested assistance or other assistance that provides benefits to people, households, or families that have low incomes” (Thrush, 2018). This is concerning for healthcare advocates, because the qualification for Ryan White services is predicated upon “means-tested assistance.” Essentially, how much money you make determines if you’re eligible for coverage.

Recent HCV incidence and prevalence reports indicate that an increasing number of new infectious occur in rural and suburban areas of the country, with higher rates of infection occurring in Injection Drug Users, particularly in people aged 18-45, and in areas where unemployment is high, educational achievement is lower, and access to healthcare services often faces several barriers. Essentially, HCV is prevalent among people and in places that are poor; people who often rely upon means-tested assistance to pay for healthcare.

As with virtually every Republican-initiated attempt to “reform” social services programs, this is a solution looking for a problem. Roughly 60% of working age, non-elderly Medicaid enrollees are working; plus, nearly 8 in 10 –  recipients (78%) live in families where at least one person works (Garfield, et al, 2018). The statistics are similar for recipients of the Supplemental Nutrition Assistance Program (SNAP)…  And for WIC…  And for virtually every other social safety net program.

76% of Louisiana's Medicaid expansion enrollees are working, caring for family members, or in school.

Photo Source: Louisiana Budget Project

Ryan White recipients, in particular, face an undue burden, as income requirements – particularly in more conservative states – are so low that working virtually any job will make them ineligible to receive coverage for medications that are prohibitively expensive. This will apply to both those mono-infected with HIV and co-infected with HCV.  For those receiving Medicaid, the burden will be just as high.

All of this stems from the Federal Poverty Level (FPL), a percentage of which determines eligibility for these means-tested programs. For an individual, the FPL is $12,140 per year in 2018. This means that an individual must make that amount, or less, to be considered “in poverty” in the United States. In states that expanded their Medicaid programs, most raised that qualification limit to 138% percent of the FPL ($16,753). The FPL percentage for Ryan White varies wildly from state to state.

This places potential recipients in a terrible position: At the current Federal Minimum Wage ($7.50/hour), an individual working 40 hours a week for 52 weeks will have an annual income of $15,080. If they cross this threshold by even a few hundred dollars, it makes them ineligible for the program, but still leaves them unable to afford the basic cost of living, much less any insurance premiums or medications they may have added to their monthly expenditures. Even with a second income, which would likely make them ineligible for services because they make “too much money,” the cost of living is so far removed from how the FPL is set, no person can reasonably expect to subsist off of that amount for any extended period of time in a First World country.

Adding work requirements to social programs also poses a logistical reality: simply demanding that “able-bodied” people “get jobs” doesn’t magically create jobs for there to be gotten. Nor are these requirements bolstered by any additional wraparound services, such as increased infrastructure spending to extend public transportation services out to far-flung locales, transportation assistance funds to cover the cost of fuel or low-cost public transportation passes.

The reality is that these “cost-saving” measures (ultimately designed to purge these programs of ‘undeserving’ recipients) will result in immeasurable costs that will be paid in human lives.

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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We Have a Cure for HCV; Few People Can Get It

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

Numerous films and novels have predicted this fate: there’s a fatal disease and someone invents a cure, but nobody can get it, and people die because of it. It’s a metaphor about the dangers of unchecked capitalism – the greedy owner of the cure who holds the rest of the world hostage until his demands are met.

And here it is – 2018, and we’ve had a cure for Hepatitis C (HCV) that’s easily tolerated since 2013, but it’s so prohibitively expensive that private and public payors, alike, have strictly limited access to it. They make patients, physicians, and pharmacists jump through as many hoops as possible to get the cure, from the strictest prerequisite abstinence guidelines, to allowing the disease to progress until it’s “bad enough” to cover it.

Medical Benefits Claim Form with the word, "REJECTED"

Photo Source: NPR

Sure, the cost of the newest drugs to cure HCV have dropped to ¼ of the introductory price of Sovaldi (Gilead), but, still – $30k for eight weeks of treatment? That’s still prohibitively expensive, even with the deep discounts and rebates given to many payors by manufacturers during the negotiation process. Those expenditures are only going to increase.

Now, there is evidence suggesting that undiagnosed HCV is more prevalent than undiagnosed HIV (Torian et al, 2018). Since the 1990s, hospitals and emergency departments have actively touted “routine HIV” screening, but have failed to deliver on those promises:

Lessons from HIV are both instructive and sobering: routine HIV screening is not truly routine; linkage continues to challenge even experienced providers; and linkage and treatment initiation vary widely across sites (Torian et al, 2018).

The findings from this study indicate not only a need to increase screening and linkages to care for HIV, but that this increase needs to be spread to HCV, as well. The latter argument, while correct, is unlikely to occur, in no small part because states and patients simply don’t have the resources to successfully implement this type of public health initiative.

Beyond just testing, minorities and Medicaid recipients – a significant portion of those infected with HCV – enjoy some of the lowest treatment rates in the nation (Wong et al, 2018). Hispanic patients were siginifantly less likely to receive treatment for HCV than white patients, and those on Medicaid, state insurance, or indigent care or no insurance were significantly less like to receive treatment than those with commercial insurance.

That last part comes to a head in rural America, where patients are far likelier to rely upon Medicaid as their primary payor for medical services, and where Injection Drug Use (IDU) of prescription opioids and/or heroin is high. In states like Ohio, Indiana, West Virginia, and Kentucky, IDU and rates of overdose go hand in hand with increased rates of both Hepatitis B and HCV.

The sad reality is that, given the existing political makeup of both state and Federal legislatures, it’s highly unlikely that the significant resources needed to effectively combat the spread of HCV will be allocated. At a time when budgets are being slashed in order to accommodate tax cuts for corporation and the wealthy, to suggest that conservative lawmakers are suddenly going to provide an exponential (or even incremental) increase in funding is unrealistic.

References:

  • Torian, L.V., Felsen, U.R., Qiang, X., Laraque, F., Rude, E.J., Rose, H., Cole, A., et al. (2018, April 04). Undiagnosed HIV and HCV Infection in a New York City Emergency Department, 2015. American Journal of Public Health 108, no. 5 (May 1, 2018): pp. 652-658. DOI: 10.2105/AJPH.2018.304321 Retrieved from: https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2018.304321
  • Wong, R.J., Jain, M.K., Therapondos, G., Shiffman, M.L., Kshirsagar, O., Clark, C., & Thamer, M. (2018, March 09). Race/ethnicity and insurance status disparities in access to direct acting antivirals for hepatitis C virus treatment. The American Journal of Gastroenterology. DOI: 10.1038/s41395-018-0033-8. Retrieved from: https://www.nature.com/articles/s41395-018-0033-8

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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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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:

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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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