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Karen M. Clements, ScD, MPH |
A UMass Medical School study suggests some patients with hepatitis C face barriers to receiving the newest medications to treat the virus. The research, led by Karen M. Clements, ScD, MPH, assistant professor of quantitative health sciences and a senior project director in Commonwealth Medicine, was published in the June edition of the Journal of Managed Care & Specialty Pharmacy.
“In order to reduce future health care costs and premature mortality associated with HCV [chronic hepatitis C virus], the number of patients receiving these potentially curative antiviral treatments must be increased,” the authors said. “This study suggests that there are barriers to treatment access in addition to the high cost of these medications that will have to be addressed in order to achieve this goal.”
The paper examined the use of sofosbuvir and simeprevir, medications that have been very effective in treating HCV, among members of MassHealth, Massachusetts’ Medicaid program.
Chronic hepatitis C can cause severe liver disease and affects 3 to 6 million people, roughly 1 to 2 percent of the U.S. population. It occurs most often in individuals with substance use disorder and more than half are intravenous drug users.
The study found use of the medications did not increase as quickly as expected considering MassHealth has few restrictions on treatment access, and treatment referral was varied. People with substance use disorders, who comprise a large portion of those with HCV, were less likely to have treatment requested than MassHealth members with more advanced liver disease, according to the authors.
Several barriers to treatment were outlined by the authors, including:
- Payers being concerned about having enough resources for all who request treatment;
- Nearly all state Medicaid programs require prior authorization for sofosbuvir and simeprevir because of limited budgets;
- Some patients may have difficulty adhering to treatment regimens; and
- Physicians may not want to treat patients they consider poor risks.
Despite the high cost of the drugs, the authors said, they may be a good value because they can reduce complications and health care costs, and improve the quality of life for people with HCV.
