Removal of medicaid restrictions were associated with increased hepatitis C virus treatment rates, but disparities persist

• DOI: 10.1111/jvh.13661
• Publication Date: 2022-03-07T13:14:17Z
• Authors: Lauren D. Nephew; Yumin Wang; Kawthar Mohamed; Deborah Nichols; Susan M. Rawl; Eric Orman; Archita P. Desai; Kavish R. Patidar; Marwan Ghabril; Naga Chalasani; Monica L. Kasting
• Keywords: Hepatitis C

Despite the release of a growing number direct-acting antivirals and evolving policy landscape, many those diagnosed with hepatitis C virus (HCV) have not received treatment. Those from vulnerable populations are at particular risk being unable to access treatment, threatening World Health Organization (WHO) HCV elimination goals. The aim this study was understand association between approvals, HCV-related changes treatment in Indiana, explore by race, birth cohort insurance type. We performed retrospective adults 05/2011-03/2021, using statewide electronic health data. Nine were defined priori. A Lowess curve evaluated trends over time. Monthly screening rates examined. Multivariable logistic regression explored predictors population (N = 10,336) 13.4% Black, 51.8% born after 1965 44.7% Medicaid recipients. Inflections four periods: (1) Interferon + DAA, (2) early antivirals, (3) expansion/optimization (4) restrictions (fibrosis/prescriber) removed. largest increase monthly during period 4, when prescriber fibrosis removed (2.4 persons per month [PPM] 1 72.3 PPM p < 0.001; 78.0% change slope). analysis showed (vs. before 1945; OR 0.69; 95% 0.49-0.98) having private insurance; 0.47; CI 0.42-0.53), but race associated lower odds treated. In conclusion, DAAs had limited impact on until Additional policies may be needed address treatment-related age disparities.