A Novel Strategy for Increasing Access to Treatment for Hepatitis C Virus Infection for Medicaid Beneficiaries
Authors: Neeraj Sood, Diane Ung, Anil Shankar, Brian L. Strom
Journal: Annals of Internal Medicine (2018)

Ideas and Opinions17 July 2018A Novel Strategy for Increasing Access to Treatment for Hepatitis C Virus Infection for Medicaid BeneficiariesNeeraj Sood, PhD, Diane Ung, JD, Anil Shankar, JD, and Brian L. Strom, MD, MPHNeeraj Sood, PhDUniversity of Southern California, Los Angeles, California (N.S.)Search for more papers by this author, Diane Ung, JDFoley & Lardner, Los Angeles, California (D.U., A.S.)Search for more papers by this author, Anil Shankar, JDFoley & Lardner, Los Angeles, California (D.U., A.S.)Search for more papers by this author, and Brian L. Strom, MD, MPHRutgers University, Newark, New Jersey (B.L.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-0186 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail An estimated 2.7 to 3.9 million persons in the United States were living with chronic hepatitis C virus (HCV) infection in 2015 (1). The annual death toll from this condition in the United States exceeds that from HIV and 59 other infectious diseases combined (2). The good news is that curative treatments first introduced in 2013 have achieved a sustained virologic response rate greater than 90% and that sustained virologic response is associated with lower mortality among patients with chronic hepatitis (3, 4). In response, the National Academies of Sciences, Engineering, and Medicine convened a committee of experts to develop ...References1. Centers for Disease Control and Prevention. Viral hepatitis: statistics and surveillance. 2018. Accessed at www.cdc.gov/hepatitis/statistics/index.htm on 10 April 2018. Google Scholar2. Ly KN, Hughes EM, Jiles RB, Holmberg SD. Rising mortality associated with hepatitis C virus in the United States, 2003-2013. Clin Infect Dis. 2016;62:1287-8. [PMID: 26936668] doi:10.1093/cid/ciw111 CrossrefMedlineGoogle Scholar3. Suwanthawornkul T, Anothaisintawee T, Sobhonslidsuk A, Thakkinstian A, Teerawattananon Y. Efficacy of second generation direct-acting antiviral agents for treatment naïve hepatitis C genotype 1: a systematic review and network meta-analysis. PLoS One. 2015;10:e0145953. [PMID: 26720298] doi:10.1371/journal.pone.0145953 CrossrefMedlineGoogle Scholar4. van der Meer AJ, Veldt BJ, Feld JJ, Wedemeyer H, Dufour JF, Lammert F, et al. Association between sustained virological response and all-cause mortality among patients with chronic hepatitis C and advanced hepatic fibrosis. JAMA. 2012;308:2584-93. [PMID: 23268517] doi:10.1001/jama.2012.144878 CrossrefMedlineGoogle Scholar5. National Academies of Sciences, Engineering, and Medicine. A National Strategy for the Elimination of Hepatitis B and C: Phase Two Report. Washington, DC: National Academies Pr; 2017. Google Scholar6. Barua S, Greenwald R, Grebely J, Dore GJ, Swan T, Taylor LE. Restrictions for Medicaid reimbursement of sofosbuvir for the treatment of hepatitis C virus infection in the United States. Ann Intern Med. 2015;163:215-23. [PMID: 26120969]. doi:10.7326/M15-0406 LinkGoogle Scholar7. AASLD/IDSA HCV Guidance Panel. Hepatitis C guidance: AASLD-IDSA recommendations for testing, managing, and treating adults infected with hepatitis C virus. Hepatology. 2015;62:932-54. [PMID: 26111063] doi:10.1002/hep.27950 CrossrefMedlineGoogle Scholar8. Chhatwal J, Kanwal F, Roberts MS, Dunn MA. Cost-effectiveness and budget impact of hepatitis C virus treatment with sofosbuvir and ledipasvir in the United States. Ann Intern Med. 2015;162:397-406. [PMID: 25775312]. doi:10.7326/M14-1336 LinkGoogle Scholar9. Rosenthal ES, Graham CS. Price and affordability of direct-acting antiviral regimens for hepatitis C virus in the United States. Infect Agent Cancer. 2016;11:24. [PMID: 27186235] doi:10.1186/s13027-016-0071-z CrossrefMedlineGoogle Scholar10. Hill A, Khoo S, Fortunak J, Simmons B, Ford N. Minimum costs for producing hepatitis C direct-acting antivirals for use in large-scale treatment access programs in developing countries. Clin Infect Dis. 2014;58:928-36. [PMID: 24399087] doi:10.1093/cid/ciu012 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Southern California, Los Angeles, California (N.S.)Foley & Lardner, Los Angeles, California (D.U., A.S.)Rutgers University, Newark, New Jersey (B.L.S.)Financial Support: None.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-0186.Corresponding Author: Neeraj Sood, PhD, University of Southern California, Verna & Peter Dauterive Hall 210, 635 Downey Way, Los Angeles, CA 90089-3333; e-mail, [email protected]usc.edu.Current Author Addresses: Dr. Sood: University of Southern California, Verna & Peter Dauterive Hall 210, 635 Downey Way, Los Angeles, CA 90089-3333.Ms. Ung and Mr. Shankar: Foley & Lardner LLP, 555 South Flower Street, Suite 3500, Los Angeles, CA 90071-2411.Dr. Strom: Rutgers University, Biomedical and Health Sciences, Stanley S. Bergen Building, 65 Berge Street, Newark, NJ 07103.Author Contributions: Conception and design: N. Sood.Analysis and interpretation of the data: N. Sood, D. Ung.Drafting of the article: N. Sood, D. Ung, A. Shankar.Critical revision of the article for important intellectual content: N. Sood, D. Ung, B.L. Strom.Final approval of the article: N. Sood, B.L. Strom.Administrative, technical, or logistic support: A. Shankar.This article was published at Annals.org on 15 May 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byClosing the hepatitis C treatment gap: United States strategies to improve retention in careThe Payer License Agreement, or “Netflix model,” for hepatitis C virus therapies enables universal treatment access, lowers costs and incentivizes innovation and competitionThe ‘Netflix plus model’: can subscription financing improve access to medicines in low- and middle-income countries?Estimating the price at which hepatitis C treatment with direct-acting antivirals would be cost-saving in JapanThe Potential Benefits of Deferred Payment for a Hypothetical Gene Therapy for Congestive Heart Failure: A Cost-Consequence AnalysisThe Ethics of Precision Rationing: Human Genetics and the Need for Debate on Stratifying Access to MedicationThe impact of direct‐acting anti‐virals on the hepatitis C care cascade: identifying progress and gaps towards hepatitis C elimination in the United StatesUniversal Screening for Hepatitis C: An Important Step in Virus EliminationAlternative State-Level Financing for Hepatitis C Treatment—The “Netflix Model”Novel purchasing strategy to increase access to HCV drugs 17 July 2018Volume 169, Issue 2Page: 118-119KeywordsDisclosureDrugsHepatitis AHepatitis C virusMotivationPatientsPopulation statisticsPrevention, policy, and public healthPrimary care physiciansTelemedicine ePublished: 15 May 2018 Issue Published: 17 July 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. 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