Studies show that less than one-third of insured hepatitis C patients receive timely treatment

CNN
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Although there are highly effective and often curative treatments for people with hepatitis C, less than a third of insured patients receive treatment within a year of diagnosis. study.

Researchers in the study, released Tuesday by the U.S. Centers for Disease Control and Prevention, said about 48,000 people who tested positive for the potentially life-threatening disease in early 2019 and late 2020 began treatment. the percentage of people who have The rate within one year was 35% for private insurance, 28% for Medicare, and 23% for Medicaid.

Hepatitis C It is caused by a virus that is spread through contact with the blood of an infected person, such as by using shared needles to inject drugs. If untreated, it can lead to lifelong infections and increase the risk of liver disease, cancer, and death.

CDC Estimate Between 2013 and 2016, more than 2 million people were infected with hepatitis C in the United States, making hepatitis C a leading cause of death. 14,242 people 2019.

“Almost a decade after highly effective treatments became available, we still see very large gaps in hepatitis C treatment. , we are missing a huge opportunity not only to save lives, but to prevent ongoing infections,” said Dr Carolyn. Wester, director of the CDC’s Viral Hepatitis Division and co-author of the new study, told CNN.

In December 2013, the U.S. Food and Drug Administration approved the first of a series of new hepatitis C treatments called direct-acting antivirals that do not contain interferon.

Expert Quote Over 95% of people are cured with this treatment, which is usually taken by mouth over a period of 2 to 3 months in tablets, but the high price makes it difficult for many to obtain.

When the treatment became available, Wester said, a two- to three-month regimen cost about $90,000 per person.That cost has fallen due to factors such as Increasing competition from other drug manufacturers remains an access barrier.

To keep her costs down, she said, insurance companies have placed limits on who can get treatment coverage, and those who are covered may still have to pay out-of-pocket costs. He added that there is

Some insurers limit coverage to certain groups of patients, such as those with evidence of liver damage, those who have abstained from drug or alcohol use for more than a month, or those who have been prescribed treatment by a specialist doctor. increase.Despite this clinical guidelines Treatment is recommended for all people with hepatitis C, with rare exceptions such as children under the age of three.

“I think there’s an unfortunate, really terrible stigma against people who inject drugs. It’s kind of like the idea that if you keep injecting drugs, you can get reinfected, so in a way the treatment is useless. It’s something,” said assistant professor Dr. Alice Worthel. A Tufts Medical Center physician who was not involved in the study. “A lot the study These drugs have been found to be safe and effective for people who use injection drugs. ”

Researchers in a new study found that people whose Medicaid program enacted at least one of these restrictions were 23% less likely to have access. Patients can receive treatment within a year of diagnosis compared to patients without restrictions in the Medicaid program.

It is important to get treatment as soon as possible after diagnosis.

“Otherwise, people often forget or are unaware of their diagnosis because hepatitis C can remain asymptomatic for years, as they often go untreated. “And what ultimately happens is that they are not linked to the treatment they need and show up much later in the health care system with advanced disease and complications that are much more difficult and costly to treat. Moreover, we have lost the opportunity to prevent contagion over the years.”

This study was published in the CDC’s Morbidity and Mortality Weekly Report, but it has not been peer-reviewed and therefore not verified by an independent expert.

The study had several limitations, including the inability to generalize findings to people without health insurance or confusion over insurance coverage. Nor did it contain any information about the patients being housed.

The researchers said, “In many ways, because we looked at diagnosed and insured patients. [these] Individuals who are set up to have the best access to care and treatment,” Wester said in a media call on Tuesday.

Additionally, the data were not specific enough to explain why each person did not receive treatment. Even so, hepatitis C treatment rates have declined each year since 2015, according to CDC emails.

“The COVID-19 disruption may have contributed to the low number of treatments in this analysis. However, other long-term barriers to access to treatment are also at work. , including state Medicaid restrictions on the types of providers who can prescribe treatment, patient eligibility restrictions, and preapproval requirements before treatment can begin,” the CDC added. The process of reviewing whether treatment is medically necessary before agreeing to pay for medicines.

“Healthcare providers, insurers, policy makers and public health professionals all need to work towards removing these eligibility restrictions,” said Wester.she added that remedy It should be available in more settings, such as primary care offices, and more testing should be done to identify people who might benefit from the treatment.

Wurcel said she remembers the day a new treatment was approved. She was compiling a list of patients she wanted to try the new treatment. Then followed an almost 10-year ‘roller coaster’ as patients had to overcome obstacles to gain access.

“The only way to end the hepatitis C epidemic is with more treatment, and one of the key multi-level strategies is to lower the price of hepatitis C drugs. It should be part of a strategy aimed at eradicating hepatitis,” she said.