Access to New Medications for Hepatitis C for Medicaid Members: A Retrospective Cohort Study

Abstract

No outside funding supported this research. Internal funding was provided by the Commonwealth of Massachusetts. Lavitas has received compensation from University of Tennessee Advanced Studies in Medicine for development of CPE activity. Graham has consulted for the National Viral Hepatitis Roundtable and the Department of Health and Human Services, has received payment from Medscape for CME development, and is employed by Trek Therapeutics. Jeffrey has received payment for guest lectures at Boston University and Harvard University. Study concept and design were primarily contributed by Clark and Clements, along with Graham, Lenz, and Jeffrey. Kunte collected the data, which were interpreted by Graham, Lenz, and Jeffrey, with assistance from Lavitas, Clark, and Clements. The manuscript was written primarily by Clements, along with O'Connell and assisted by Graham, and revised by all the authors.

Shift in disparities in hepatitis C treatment from interferon to DAA era: A population‐based cohort study

“…Similarly, we found people with a history of drug use and those on OST showed a trend towards receiving DAAs, although it was not significant for DAAs+PegIFN/RBV. These findings are consistent with data from the United States on HIV co‐infection and advanced‐stage liver disease but not for drug use . In these studies, as well as in another study from Switzerland, people with a history of substance use were less likely to receive new DAAs .…”

“…These findings are consistent with data from the United States on HIV co-infection and advanced-stage liver disease but not for drug use. [27][28][29] In these studies, as well as in another study from Switzerland, people with a history of substance use were less likely to receive new DAAs. 27,28,30 HCV treatment does not confer immunity, and PWIDs who continue to inject without optimal harm reduction (such as opioid substitution therapy) are at a higher risk of re-infection.…”

“…[27][28][29] In these studies, as well as in another study from Switzerland, people with a history of substance use were less likely to receive new DAAs. 27,28,30 HCV treatment does not confer immunity, and PWIDs who continue to inject without optimal harm reduction (such as opioid substitution therapy) are at a higher risk of re-infection. 14,31,32 Because of the high cost of HCV treatment, re-infection remains a major concern for decision-makers as well as physicians, which may reduce the probability for PWIDs to be treated with DAAs.…”

“…As in other recent studies, our data show that people with cirrhosis and decompensated cirrhosis are more likely to get HCV treatment as people with fibrosis stage F2 and higher were prioritized for treatment. [27][28][29] Given the well-known poor tolerability of PegIFN-based therapy in patients with decompensated cirrhosis, decreased effectiveness and high risk of significant, sometimes fatal, treatmentassociated adverse risks, it is not surprising that there is a shift towards IFN-free DAAs in patients with cirrhosis especially given the relatively good safety profile and enhanced efficacy. Furthermore, given the reported improvement in liver function experienced by a significant proportion of decompensated cirrhotic patients treated with IFN-free DAAs, thereby potentially avoiding a liver transplant, this trend is most likely going to continue.…”

Clinical Evaluation of Terap C Vaccine in Combined Treatment with Interferon and Ribavirin in Patients with Hepatitis C

“…The advent of newer DAAs (eg, sofosbuvir, simeprevir, daclatasvir, ledipasvir, ombitasvir/paritaprevir/ritonavir combination, and dasabuvir) have further increased the SVR rates in genotype 1 patients to 80% to 90%, with a shorter course of therapy, fewer monitoring requirements, and without the need to supplement with P-IFN. 21 These HCV drug regimens have dramatically improved treatment efficacy, despite higher drug prices. In Cuba, few patients have been treated with these antivirals.…”