5 Things to Know About Hepatitis C Screening and Treatment

May is National Hepatitis Awareness Month, and the CDC has designated May 19, 2016, as Hepatitis Testing Day, an opportunity to raise awareness of the need for screening. CDC estimates that 3.5 million Americans may have hepatitis C virus (HCV), although many don’t know it.

The American Journal of Managed Care just published a special issue on the policy questions that have come with FDA approval of direct-acting antivirals (DAAs). These therapies can cure HCV, reducing the risk of liver cancer or the need for a transplant, but many payers have balked at the upfront cost.

Here are 5 things to know about hepatitis C screening and treatment:

1. Early treatment could yield long-term savings. One study in the AJMC special issue found that treating HCV patients at early stages could save Medicare between $4 billion and $11 billion in 20 years. Commercial insurers would see savings of at least $10 billion over that period. A separate study put the social value of aggressive screening and treatment at $824 billion. (These studies were funded by AbbVie.)

2. But, the short-term costs are enormous. With the list price for a 12-week course of treatment averaging $84,000, many payers and state Medicaid officials have balked at treating patients until their disease worsens. The problem, as authors point out, is that commercial payers currently lack financial incentives to fund HCV treatment for early-stage patients, because the savings may be realized by others, especially Medicare.

3. In the meantime, the death toll climbs. CDC reported last week that more people than ever died from HCV in 2014, and that cases of acute disease doubled between 2010 and 2014. Deaths from HCV were 19,659, according to the data, and a separate study by CDC authors found that hepatitis C-related mortality was the top cause of death among 60 infectious diseases.

4. The US Preventive Service Task Force recommends screening all baby boomers. The recommendation for every person born between 1945 and 1965 to have a one-time screening came in late 2013, just as DAAs were reaching the market. Risk rises with this age group because blood products were not screened for HCV before 1989. But anyone who has used intravenous drugs should also be screened, because past or current injection drug use is the leading cause of infection.

5. You can learn more at a Capitol Hill briefing. “Ending Hepatitis C: The Value of Curing the Nation’s Deadliest Blood-Borne Disease,” will take place May 23, 2016, from noon to 1:30 p.m. at the Dirksen Senate Office Building, Room 106. Presented by AJMC and the National Viral Hepatitis Roundtable (NVHR), the briefing will feature the editor of the AJMC special issue, Jay Bhattacharya, MD, PhD, of Stanford University; and 3 authors: Ryan Clary, NVHR executive director; Anupam Jena, MD, PhD, of Harvard Medical School; and Darius Lakdawalla, PhD, of the University of Southern California. Click here to register.