Two new publications point to the value of treating hepatitis C – early, aggressively and alongside heightened screening efforts.
Expert Consultation Report
The Department of Health and Human Services recently released a report on its September 2016 meeting of stakeholders, “Expert Consultation on the Evidence for Early Hepatitis C Treatment in the United States.” The event convened 34 advocates, researchers, federal partners, and health plan officials to explore barriers and solutions to accessing hepatitis C treatment. Toward helping the United States realize “the full potential benefit of the newly available, highly effective curative treatment[s],” the group discussed:
- Coverage restrictions
- Cost and price of direct-acting antiviral cures
- Improving hepatitis C surveillance and health care data
- Hepatitis C treatment outcomes
- Health care system capacity
Curative treatments have proven highly effective, yet only a “small proportion” of the nation’s 3.2 million hepatitis C patients have been treated. The report pinpoints health plan restrictions as a key factor in limiting access. Specific barriers include restrictions on which providers can prescribe the cures, limited choice among treatment regimens, and patient eligibility factors such as liver fibrosis score and substance use history. Low screening rates also present challenges.
Confusion about medication pricing may also impede treatment, the report explains. The cost of treatment may be only about one-fourth of the reported list price of some hepatitis C cures, depending upon the prescription and the negotiations by a patient’s pharmacy or health plan. Nevertheless, the report encourages “realistic, time-phased rollout plans” for treatment that acknowledge cost impact.
National Viral Hepatitis Action Plan
The report’s findings intersect with another newly released HHS document, the National Viral Hepatitis Action Plan, 2017-2020. Provided as an update on past strategy, the plan lays out four broad goals:
- Prevent new viral hepatitis infections
- Reduce deaths and improve the health of people living with viral hepatitis
- Reduce viral hepatitis health disparities
- Coordinate, monitor, and report on implementation of viral hepatitis activities.
Strategies include increasing community awareness, encouraging prevention and addressing treatment in correctional settings. The plan looks to improve testing and access to care, particularly among high-risk or underserved populations.
Since direct-acting antivirals became available in 2014, patients have struggled to access the costly yet effective cures. Market forces have pushed the medications’ prices down, helping to alleviate some barriers. And certain state Medicaid systems have slowly begun to improve treatment access for their patients. But, as HHS’ reports suggest, a significant number of affected people with hepatitis C remain untreated – despite obvious benefits for both individual patients and public health.