Supplement
Issue:
Battling a Stormy C: Addressing Managed Care Challenges and Opportunities in Management of Hepatitis C [CME/CPE]
Volume:
18
Number:
14 Suppl
Release date: December 5, 2012 |  Expiration date: December 5, 2013
Estimated time to complete activity:  2.5 hours
Type of Activity: Knowledge  |  Medium: Print with Internet-based posttest, evaluation, and request for credit

This activity is supported by an educational grant from Merck & Co, Inc and Bristol-Myers Squibb.

Intended Audience
Medical directors, pharmacy directors, specialty pharmacists, and other managed care professionals who oversee the care of patients with hepatitis C.

Statement of Educational Need
Hepatitis C virus (HCV) infects approximately 3% of the world’s population and has been declared a global health threat by the World Health
Organization due to its impact in terms of morbidity and mortality. An estimated 75% of individuals who acquire HCV develop persistent chronic
HCV infection, with associated risk of progressive liver disease, cirrhosis, liver failure, or hepatocellular carcinoma. These complications and comorbidities
lead to increased utilization of healthcare resources among HCV-infected patients. In the United States, HCV is the leading cause of liver
disease–related death and end-stage liver disease requiring transplantation. Moreover, the burden of HCV-related morbidity and mortality continues
to rise, because many individuals infected with HCV in the 1970s and 1980s are now facing increased risk of mortality after decades of progression to
advanced liver disease. Liver disease has overtaken drug-related harm as the major cause of mortality in HCV-infected individuals in many settings.

Improving HCV management and outcomes involves addressing practice gaps in screening and diagnosis, as well as focusing research efforts into newer
therapies that may overcome limitations of current treatments. The development and approval of direct-acting antiviral (DAA) therapy (eg, boceprevir,
telaprevir) for chronic HCV infection has generated considerable optimism, with studies indicating significant improvement in treatment responses
with the addition of DAAs to traditional interferon-based regimens. These therapeutic advances are essential, since the high HCV incidence 20 to 30
years ago is now reflected in the growing burden of advanced HCV-related liver disease. Without effective therapeutic intervention, the projected liver
disease burden will continue to rise for at least the next 1 to 2 decades (and beyond) in those settings that have experienced ongoing high rates of HCV
transmission.

Educational Objectives
Upon completion of the educational activity, the participant should be able to:
  • Describe the clinical and economic burden associated with HCV infection
  • Evaluate the efficacy and adverse effects of standard-of-care therapies in management of HCV infection and efforts to optimize viral eradication
  • Assess the potential of new and emerging HCV therapeutic strategies, including safety and efficacy data in regard to improving treatment response
    and patient outcomes
  • Examine managed care considerations in the management of HCV, including strategies for determining cost-effectiveness of treatment and the
    impact of changing treatment outcomes on managed care organizations
  • Identify challenges in maintaining adherence with HCV treatment and discuss solutions in promoting adherence

Activity Fee
Physician: This activity is free of charge for physician participants requesting AMA PRA Category 1 CreditTM.
Pharmacist: The activity is free for participants submitting evaluation forms and posttests online for pharmacy credit. For participants submitting their posttests/evaluation forms and requests for credit via fax or mail, there is a nominal fee of $10.00.

Disclosure Policy
According to the disclosure policies of Physicians’ Education Resource, LLC, and Pharmacy Times Office of Continuing Professional Education, all persons who are in a position to control content are required to disclose any relevant financial relationships with commercial interests. If a conflict is identified, it is the responsibility of Physicians’ Education Resource and Pharmacy Times Office of Continuing Professional Education to initiate a mechanism to resolve the conflict(s). The existence of these relationships is not viewed as implying bias or decreasing the value of the activity. All educational materials are reviewed for fair balance, scientific objectivity of studies reported, and levels of evidence.

Physician Credit
Accreditation Statement / Credit Designation
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Physicians’ Education Resource and Pharmacy Times Office of Continuing Professional Education. Physicians’ Education Resource is accredited by the ACCME to provide continuing medical education for physicians.

Physicians’ Education Resource designates this journal-based CME activity for a maximum of 2.5 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Pharmacist Credit
Accreditation and Credit Designation
Pharmacy Times Office of Continuing Professional Education is accredited by the Accreditation Council for Pharmacy Education (ACPE)
as a provider of continuing pharmacy education. This activity is approved for 2.5 contact hours (0.25 CEUs) under the ACPE universal
activity number 0290-9999-12-100-H01-P. The activity is available for CE credit through December 5, 2013.

Obtaining Credit
Participants must read each article in this supplement, complete the posttest (achieving a passing score of 70% or higher), and complete an evaluation and request for credit. Detailed instructions on obtaining CE credit are included on the evaluation/posttest page contained in this supplement.

Faculty
Tram T. Tran, MD
Director, Hepatology
Medical Director, Liver Transplant
Associate Professor of Medicine
Cedars-Sinai Medical Center
Los Angeles, California

A. Scott Mathis, PharmD
Department of Pharmacy
Monmouth Medical Center
Long Branch, New Jersey


Faculty Disclosures
These faculty have disclosed the following relevant commercial financial relationships or affiliations in the past 12 months.

Tram T. Tran, MD, has disclosed the following relevant commercial financial relationship:
Consultant/Advisory Board:  Vertex Pharmaceuticals

A. Scott Mathis, PharmD,  has no relevant financial relationships with commercial interests to disclose.

The American Journal of Managed Care 
Publishing Staff—Jeff D. Prescott, PharmD, RPh; Kara Guarini, MS; and Ida Delmendo have no relevant financial relationships with commercial interests to disclose.

Pharmacy Times Office of Continuing Professional Education and Physicians’ Education Resource, LLC 
Planning Staff—Judy V. Lum, MPA; and Elena Beyzarov, PharmD, have no relevant financial relationships with commercial interests to disclose.

Signed disclosures are on file at the office of The American Journal of Managed Care, Plainsboro, New Jersey.


Opinions expressed by authors, contributors, and advertisers are their own and not necessarily those of Clinical Care Targeted Communications, LLC, d/b/a Managed Care & Healthcare Communications, LLC, the editorial staff, or any member of the editorial advisory board. Clinical Care Targeted Communications, LLC, d/b/a Managed Care & Healthcare Communications, LLC, is not responsible for accuracy of dosages given in articles printed herein. The appearance of advertisements in this publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality, or safety. Clinical Care Targeted Communications, LLC, d/b/a Managed Care & Healthcare Communications, LLC, disclaims responsibility for any injury to persons or property resulting from any ideas or products referred to in the articles or advertisements.

Disclaimer
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

System Requirements
PC-based participants
Windows 7, Vista, XP, 2003 Server, or 2000

Macintosh®-based participants
Required: Mac OS X 10.4.11 (Tiger) or newer

© 2012 Managed Care & Healthcare Communications, LLC
ARTICLES
Tram T. Tran, MD
Tram T. Tran, MD
A. Scott Mathis, PharmD
AUTHOR INDEX
CE/CME QUIZ