Research and Data

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This page contains links to research and data to support HCV treatment access advocacy work.

Hepatitis C: The State of Medicaid Access November 2016

In this report, NVHR and the Harvard Law Center for Health Law and Policy Innovation evaluate the barriers to hepatitis C treatment access in each state's Medicaid program. The report updates and expands upon initial Medicaid 2014 fee-for-service (FFS) surveys, and documents the current state of Medicaid FFS and managed care organization (MCO) HCV treatment access through October 2016.

Elbasvir–Grazoprevir to Treat Hepatitis C Virus Infection in Persons Receiving Opioid Agonist Therapy August 2016
Hepatitis C virus (HCV) infection is common in persons who inject drugs (PWID). This study found that patients with HCV infection who were receiving OAT and treated with elbasvir–grazoprevir had high rates, regardless of ongoing drug use. These results support the removal of drug use as a barrier to interferon-free HCV treatment for patients receiving opioid agonist therapy.

Surveillance for Viral Hepatitis – United States, 2014 May 4, 2016
CDC released new viral hepatitis surveillance data from 2014 in May of 2016. The reports highlights the alarming death toll of hepatitis C in the United States, the rise in new hepatitis C infections, and the continued public health problem of chronic hepatitis B.

The American Journal of Managed Care: Special Hepatitis C Issue  May 2, 2016
American Journal of Managed Care (AJMC)
The AJMC issued a special edition on hepatitis C. The publication unveils new research underscoring the direct and indirect benefits of universal access to cures for hepatitis C. The issue also features a commentary by NVHR Executive Director Ryan Clary.

"On-Treatment Illicit Drug Use Did Not Impact Treatment Outcome During Therapy With Ledipasvir/Sofosbuvir With or Without Ribavirin in the Phase 3 ION-1 Study"  April 2016
Grebely et al., 2016, Reported by Jules Levin at NATAP.
In a study of over 99 sites in the U.S. and Europe, researchers found that drug use during HCV treatment had no effect on treatment adherence and no clinically meaningful impact on treatment outcome.

Annual Report to the Nation on the Status of Cancer, 1975-2012, featuring the increasing incidence of liver cancer
March 9, 2016
This report, released by CDC, demonstrates that while substantial progress has been made against cancer overall, a rapidly increasing number of Americans are developing and dying from liver cancer. Most alarmingly, the report states that hepatitis B and C are the leading contributing factors to liver cancer in the United States. Hepatitis C related factors contribute to 50% of liver cancer cases in the United States, and hepatitis B related factors contribute to 15% of liver cancer cases.

"C-EDGE CO-STAR: Efficacy of Elbasvir/Grazoprevir in HCV-Infected Persons Who Inject Drugs Receiving Opioid Agonist Therapy"  November 2015 
J Grebely, et al., 2016
In this study, Elbasvir/Grazoprevir demonstrated high efficacy in HCV-infected people who inject drugs (PWID) receiving opiate agonist therapy. Study results show high medication adherence and supports treating PWID on opiate substitution therapy. See associated press release from Merck & Co., Inc. here.

Restrictions for Medicaid Reimbursement of Sofosbuvir for the Treatment of Hepatitis C Infection in the United States"  August 4, 2015 
Barua et al., 2015, Annals of Internal Medicine 
This study systematically evaluated state Medicaid policies for the treatment of hepatitis C virus (HCV) infection with sofosbuvir in the U.S. Current restrictions seem to violate federal Medicaid law, which requires states to cover drugs consistent with their U.S. Food and Drug Administration labels.

"Aging will affect Medicare's hepatitis C mortality and cost"  July 16, 2015
Pyenson et al., 2015, Milliman Report 
Baby Boomers make up the majority of HCV-infected people in the U.S. This paper examines the mortality and cost dynamics affecting Medicare as the majority of HCV-infected people age into Medicare.

"The Cost-effectiveness, Health Benefits, and Financial Costs of New Antiviral Treatments for Hepatitis C Virus"  July 15, 2015
Rein et al., 2015, Clinical Infectious Diseases 
This article explores the cost-effectiveness of new DAA HCV treatments. Grebely et al. found that new treatments are cost-effectiveness per person treated, but pent-up demand for treatment may create challenges for financing.

"Improving Patient Access to Hepatitis C Cures: A White Paper from the Hepatitis Therapy Access Physicians Working Group"  July 2015
Hepatitis Therapy Access Physicians Working Group
The mission of Hepatitis Therapy Access Physicians Working Group is to ensure the perspectives of hepatologists, gastroenterologists, infectious diseases specialists and other clinicians treating patients suffering from hepatitis, are shared with policymakers considering issues impacting access to hepatitis therapies. This paper highlights that policy solutions must reconcile societal needs with the needs of current patients, as well as the needs of those who may not even know they are infected.

"Limited Access to New Hepatitis C Virus Treatment Under State Medicaid Programs"  June 30, 2015 
Canary et al., 2015, Annals of Internal Medicine
Treatment of patients with HCV infection is cost-effective from a societal point of view, but the combination of the high cost of treatment and insufficient Medicaid budgets precludes programs from providing widespread access to treatment. The effects of prior approval policies for new HCV treatments on patient outcomes warrant continued investigation.

"Why We Should Be Willing to Pay for Hepatitis C Treatment"  June 2015
Chhatwal et al., 2015, Clinical Gastroenterology and Hepatology 
This paper examines the argument for why we should be willing to pay for hepatitis C treatment by examining its cost-effectiveness and linking this to the possibility of eliminating hepatitis C.

"Examining Hepatitis C Treatment Access: A Review of Select State Medicaid Fee-for-Service and Managed Care Programs"  March 2015 
The Center for Health Law & Policy Innovation of Harvard Law School 
The Center for Health Law and Policy Innovation of Harvard Law School prepared ten state profiles, which gave an overview of HCV in these states, examined the accessibility of Sovaldi through Medicaid fee-for-service programs, and in five select states also examined restrictions in Medicaid managed care plans that can differ from fee-for-service programs.