Inconsistency in HCV Treatment: New CDC Report

Although direct-acting antiviral (DAA) treatment is highly effective in the treatment of hepatitis C virus (HCV), researchers have found that very few of the insured patients end up getting timely treatment.

“Over 2 million adults in the United States have HCV infection, and it contributes to approximately 14,000 deaths a year,” the authors wrote while drawing attention to the disparities in treatment of HCV based on initiation of treatment, sex, age, and medical insurance coverage. The findings have been published in the Morbidity and Mortality Weekly Report by the US Centers for Disease Control and Prevention (CDC).

The team gathered information about adults between ages 18 and 69 diagnosed with HCV from January 2019 to October 2020 using HealthVerity, an administrative claims and encounters database. All patients included were continuously enrolled in some type of insurance before and after diagnosis. The study aimed to understand the association between initiation of DAA treatment and sex, age, race, payor, and Medicaid restriction status.

Out of the 47,687 enrolled patients who tested positive for HCV, only 23% with Medicaid and 28% with Medicare initiated the DAA treatment within the first year of diagnosis, compared to 35% of the patients with private insurance. Adjusted odds of treatment initiation were lower among those with Medicaid (aOR = 0.54; 95% CI = 0.51–0.57) and Medicare (aOR = 0.62; 95% CI = 0.56–0.68) than among those with private insurance.

The team also noted that younger adults were less likely to receive initial treatment compared to older patients, regardless of insurance type. Patients in states with Medicaid treatment restrictions were less likely to initiate DAA treatment than in states without such restrictions. Among Medicaid recipients, Black or African American patients were less likely to receive initial treatment for HCV than their White counterparts.

If initiated within the first 8 to 12 weeks of diagnosis, DAA treatment has been known to cure more than 95% of the cases, according to CDC. However, the newly released report brings to light the significant disparity in existing treatment.

“Unrestricted access to timely DAA treatment is critical to reducing viral hepatitis-related mortality, disparities, and transmission,” the authors advised. “Treatment saves lives, prevents transmission, and is cost saving.”

—Priyam Vora

Reference:
Thompson W, Symum H, Sandul A et al. Vital Signs: Hepatitis C Treatment Among Insured Adults — United States, 2019–2020. News Release. The US Centers for Disease Control and Prevention; August 09, 2022.  DOI: http://dx.doi.org/10.15585/mmwr.mm7132e1