Insurance Denials for New Hepatitis C Drugs Remain High Nationwide, Study Suggests
Highly effective drugs that can cure chronic hepatitis C infection in approximately 95 percent of patients first became available in the
For the prospective cohort study, researchers used data from
During the study period, about one-third (35.5 percent) of patients who were prescribed a direct-acting antiviral regimen for chronic hepatitis C were denied the treatment by their insurer, the study found. Denials were more common among patients with commercial insurance: 52.4 percent of these patients' prescriptions were denied compared to 34.5 percent among Medicaid beneficiaries and 14.7 percent among Medicare patients, respectively. The overall incidence of denials for the hepatitis C drugs across all insurance types also increased during the study period, from 27.7 percent in the first quarter to 43.8 percent in the last quarter.
"From a clinical standpoint, patients who are denied access to hepatitis C treatment are going to remain at risk for the development of liver complications like cirrhosis, hepatic decompensation, and liver cancer," said study senior author Vincent Lo Re III, MD, MSCE, an associate professor of Infectious Disease and Epidemiology in the
Current guidelines from the
"Failure to treat and cure chronic hepatitis C infection also maintains a reservoir for transmission, which certainly can add to increasing incidence of the infection, especially given the growing opioid epidemic" said
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