Vital Signs : Hepatitis C Treatment Among Insured Adults - United States, 2019-2020

Details

• Alternative Title:
  Hepatitis C Treatment Among Insured Adults - United States, 2019-2020
• Personal Author:
  Thompson, William W. ; Symum, Hasan ; Sandul, Amy ; Gupta, Neil ; Patel, Priti ; Nelson, Noele ; Mermin, Jonathan ; Wester, Carolyn
• Corporate Authors:
  National Center for HIV, Viral Hepatitis, STD, and TB Prevention (U.S.). Division of Viral Hepatitis. ; National Center for HIV, Viral Hepatitis, STD, and TB Prevention (U.S.). Office of the Director.
• Description:
  What is already known about this topic? Direct-acting antiviral (DAA) treatment is recommended for nearly all persons with hepatitis C and cures ≥95% of cases. Treatment saves lives, prevents transmission, and is cost saving. ; What is added by this report? Treatment rates are low overall and vary by age and insurance payor. DAA treatment is lowest among young adults aged 18-29 years and Medicaid recipients, and within Medicaid, among persons reporting Black or other race and persons in states with treatment restrictions. ; What are the implications for public health practice? Timely initiation of DAA treatment, regardless of insurance type, is critical to reducing viral hepatitis-related mortality, disparities, and transmission. ; Introduction: Over 2 million adults in the United States have hepatitis C virus (HCV) infection, and it contributes to approximately 14,000 deaths a year. Eight to 12 weeks of highly effective direct-acting antiviral (DAA) treatment, which can cure ≥95% of cases, is recommended for persons with hepatitis C. ; Methods: Data from HealthVerity, an administrative claims and encounters database, were used to construct a cohort of adults aged 18-69 years with HCV infection diagnosed during January 30, 2019-October 31, 2020, who were continuously enrolled in insurance for ≥60 days before and ≥360 days after diagnosis (47,687). Multivariable logistic regression was used to assess the association between initiation of DAA treatment and sex, age, race, payor, and Medicaid restriction status; adjusted odds ratios (aORs) and 95% CIs were calculated. ; Results: The prevalence of DAA treatment initiation within 360 days of the first positive HCV RNA test result among Medicaid, Medicare, and private insurance recipients was 23%, 28%, and 35%, respectively; among those treated, 75%, 77%, and 84%, respectively, initiated treatment within 180 days of diagnosis. Adjusted odds of treatment initiation were lower among those with Medicaid (aOR = 0.54; 95% CI = 0.51-0.57) and Medicare (aOR = 0.62; 95% CI = 0.56-0.68) than among those with private insurance. After adjusting for insurance type, treatment initiation was lowest among adults aged 18-29 and 30-39 years with Medicaid or private insurance, compared with those aged 50-59 years. Among Medicaid recipients, lower odds of treatment initiation were found among persons in states with Medicaid treatment restrictions (aOR = 0.77; 95% CI = 0.74-0.81) than among those in states without restrictions, and among persons whose race was coded as Black or African American (Black) (aOR = 0.93; 95% CI = 0.88-0.99) or other race (aOR = 0.73; 95% CI = 0.62-0.88) than those whose race was coded as White. ; Conclusions and Implications for Public Health Practice: Few insured persons with diagnosed hepatitis C receive timely DAA treatment, and disparities in treatment exist. Unrestricted access to timely DAA treatment is critical to reducing viral hepatitis-related mortality, disparities, and transmission. Treatment saves lives, prevents transmission, and is cost saving. ; Suggested citation for this article: Thompson WW, Symum H, Sandul A, et al. Vital Signs: Hepatitis C Treatment Among Insured Adults - United States, 2019-2020. MMWR Morb Mortal Wkly Rep. ePub: 9 August 2022. ; mm7132e1.htm?s_cid=mm7132e1_w ; mm7132e1-H.pdf
• Subjects:
  • Antiviral Agents
  • Antiviral Agents / therapeutic use
  • Hepatitis C
  • Hepatitis C / drug therapy
  • Hepatitis C, Chronic
  • Hepatitis C, Chronic / drug therapy
  • Insurance, Health
  • Medicaid
• Source:
  MMWR: Morbidity and Mortality Weekly Report 2022; v. 71 Early Release
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• ISSN:
  0149-2195 (print) ; 1545-861X (digital)
• Document Type:
  Text
• Corporate as Subject:
  Vital Signs
• Genre:
  Journal Article
• Place as Subject:
  United States
• Pages in Document:
  7 pdf pages
• Volume:
  71
• Download URL:
  https://stacks.cdc.gov/view/cdc/120092/cdc_120092_DS1.pdf
• File Type:
  [PDF - 482.84 KB]
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR)
• Main Document Checksum:
  urn:sha-512:28a215fb30b853a07d7fa657ad07525babf4898c9f4ca487da9bf243aefbce21c2116bf7bf1d3d543331754032f217bfe77019d946735079c39c2d0ceb0b4718