Suppressing the Hepatitis C Virus: Barriers to Care
- Patients are untested or unaware of their diagnosis
- Fear of toxicity of treatment based on experiences with interferon based regimens
- Cost of new medications including insurance deductibles and copays
- Insurance companies’ requirements for staging severity by fibrosis scores (F0-4) before approving medications only for advanced disease (F3,4) despite broader recommendations from professional societies.
- Insurance companies’ requirements that only subspecialists in Gastroenterology and Infectious Disease can prescribe the medications
- Completing treatment of comorbid conditions and surgeries prior to committing to 3 months of treatment
- Need to develop a support network with specialty pharmacies and alcohol and substance abuse programs
Identifying and assessing a patient for treatment requires a complex assessment of the medical conditions, severity of fibrosis and necrosis and psychosocial issues. A patient who is ready for treatment has required 6-10 encounters prior to starting medication. Treatment by a specialist further delays the start of treatment. Experts predict that there are not enough specialists to treat the 2-4 million patients expected to be eligible over the next 5-10 years. Integrating the management of Hepatitis C into primary care training is thus essential to the future management of uncomplicated cases. The presenter will combine case studies with updated registry data to assess “real world” barriers to Hepatitis C patients.
Learning Areas:Administer health education strategies, interventions and programs
Chronic disease management and prevention
List barriers to accessing treatment of Hepatitis C Explain the importance of fibrosis scores in eligibility for treatment of Hepatitis C
Keyword(s): Hepatitis C, Chronic Disease Management and Care
Qualified on the content I am responsible for because: I am the faculty member responsible for guiding the development of this project and supervising volunteers, research assistants and internal medicine residents to review our experience with Hepatitis C and HIV in our clinic. We have been evaluating data for the past 2 years in both the inpatient and out patient setting.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.