by Amanda Conschafter, blog editor
The near elimination of hepatitis C could be in sight, suggests new research from Yale University. Published December 1 in Clinical Infectious Diseases, the university’s study used a transmission model to predict the effect of new hepatitis C cures on the U.S. population over time. Researchers found that increasing the number of patients treated each year by a factor of four could “virtually eliminate” hepatitis C among non-injecting patients within a decade.
Increasing screening could also help reduce infection rates. However, treatment and screening alone will not mitigate widespread hepatitis C among patients who actively inject drugs, the study explains. Researchers noted that these patients might need enhanced screening and behavioral interventions, such as needle-exchange programs.
As noted by the study, curative direct-acting antiviral treatments are effective in more than 90% of patients. Yet access for patients remains a challenge. As Yale reported in August, about one in every four patients is initially denied access to a hepatitis C cure.
Though a few states, such as Connecticut, offer patients unfettered access to hepatitis C cures, others hinder treatment through labyrinthine prior authorization processes. Several patient groups have lodged discrimination complaints over these health plans’ designs.
In response, the Centers for Medicare and Medicaid Services issued a November 2015 notice reminding state Medicaid systems of their legal obligation to patients. State programs need to allow patients approved and medically necessary treatments, the notice pointed out. CMS also highlighted the importance of upholding the Affordable Care Act’s non-discrimination provisions.
Individual states must now determine how to interpret and implement CMS’ notice. Yet one thing seems certain: the annual, four-fold increase in treatment envisioned by Yale’s research team would require a significant overhaul of how state Medicaid systems get hepatitis C patients the treatment they need.