Treatment is crucial
The first direct-acting antiviral (DAA) for hepatitis C was approved in 2011, and an oral fixed-dose combination antiviral was approved in 2014, ushering in treatments with cure rates far exceeding those with interferon-based therapy.
But until recently, Medicaid patients in Maryland seeking DAA therapy for hepatitis C required prior authorization, with initial restrictions related to disease stage, substance use, and provider type, according to Dr. Mehta.
Gradually, those restrictions were lifted, Dr. Mehta added, and all were eliminated by 2019.
Dr. Cepeda urges clinicians to treat patients infected with hepatitis C immediately.
“There are really important implications on both reducing liver disease progression and all-cause mortality,” he said.
“Hep C is just one part of a whole constellation of health care delivery [and] of treating all of the other potential problems that might need to be addressed – especially with people who inject drugs,” Dr. Cepeda added. “Getting them into care is really, really important.”
The study was funded by the National Institutes of Health. Dr. Cepeda and Dr. Corcorran report no relevant financial relationships. Dr. Mehta reports receiving payments or honoraria and travel support from Gilead Sciences, the makers of the oral hepatitis C medication ledipasvir/sofosbuvir (Harvoni), as well as equipment, materials, drugs, medical writing, gifts, or other services from Abbott, which sells hepatitis C diagnostics. Dr. Thomas reports ties to Excision Bio and to Merck DSMB.
A version of this article first appeared on Medscape.com.