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Medicaid hepatitis c

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https://www.readbyqxmd.com/read/27668564/overview-of-comprehensive-hepatitis-c-virus-medication-management-in-a-state-medicaid-program
#1
Pavel Lavitas, Mark Tesell, Tasmina Hydery, Bonnie C Greenwood, Mylissa Price, Kimberly Lenz, Paul Jeffrey
BACKGROUND: Breakthrough direct-acting antivirals set a new standard in the management of hepatitis C virus (HCV) with regard to cure rates and improved tolerability; however, the health care system is challenged by the cost of these medications. OBJECTIVE: To describe the effect of a comprehensive HCV medication management program on optimized regimen use, prior authorization (PA) modifications, and medication cost avoidance in a state Medicaid program. METHODS: This program consists of a 2-tiered prescriber outreach: (1) regimen outreach to promote optimized regimen selection and (2) refill outreach to support medication adherence...
October 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27525983/health-disparities-in-hepatitis-c-screening-and-linkage-to-care-at-an-integrated-health-system-in-southeast-michigan
#2
Kassem Bourgi, Indira Brar, Kimberly Baker-Genaw
With recommended screening for hepatitis C among the 1945-1965 birth cohort and advent of novel highly effective therapies, little is known about health disparities in the Hepatitis C care cascade. Our objective was to evaluate hepatitis C screening rates and linkage to care, among patients who test positive, at our large integrated health system. We used electronic medical records to retrospectively identify patients, in the birth cohort, who were seen in 21 Internal Medicine clinics from July 2014 to June 2015...
2016: PloS One
https://www.readbyqxmd.com/read/27510752/frequency-of-and-factors-associated-with-receipt-of-liver-related-specialty-care-among-patients-with-hepatitis-c-in-the-chronic-hepatitis-cohort-study
#3
Monique A Foster, Jian Xing, Anne C Moorman, Joseph Boscarino, Stuart C Gordon, Mei Lu, Loralee Rupp, Mark A Schmidt, Connie M Trinacty, Fujie Xu, Scott D Holmberg, Philip R Spradling
BACKGROUND: Linking persons with hepatitis C virus (HCV) to care and treatment is critical to reduction in disease burden; typically, this entailed referral to a specialist. However, data regarding the frequency and factors associated with referral among patients in healthcare organizations (HCOs) are lacking. METHODS: Among persons in four US HCOs with newly diagnosed HCV during 2006-2011, we determined the frequency of liver-related specialist care after diagnosis...
August 10, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27492142/chronic-hepatitis-c-virus-hcv-burden-in-rhode-island-modelling-treatment-scale-up-and-elimination
#4
A I Soipe, H Razavi, D Razavi-Shearer, O Galárraga, L E Taylor, B D L Marshall
We utilized a disease progression model to predict the number of viraemic infections, cirrhotic cases, and liver-related deaths in the state of Rhode Island (RI) under four treatment scenarios: (1) current HCV treatment paradigm (about 215 patients treated annually, Medicaid reimbursement criteria fibrosis stage ⩾F3); (2) immediate scale-up of treatment (to 430 annually) and less restrictive Medicaid reimbursement criteria (fibrosis stage ⩾F2); (3) immediate treatment scale-up and no fibrosis stage-specific Medicaid reimbursement criteria (⩾F0); (4) an 'elimination' scenario (i...
August 5, 2016: Epidemiology and Infection
https://www.readbyqxmd.com/read/27414001/the-time-and-cost-investment-required-to-obtain-and-initiate-direct-acting-antiviral-therapy
#5
Veronica Loy, Tamara Benyashvili, William Adams, Douglas Pavkov, Meghan O'Mahoney, Scott J Cotler
BACKGROUND: Obtaining direct acting antiviral (DAA) medications for treatment of hepatitis C virus infection (HCV) is labor-intensive for providers. The purpose of this study was to assess the amount of unbillable time and to estimate the financial burden of obtaining DAAs for HCV. METHODS: Patients prescribed DAA therapy from 9/30/2014- 3/19/2015 at an academic hepatology practice were enrolled prospectively. Providers recorded the amount of time required to obtain HCV therapy for each patient...
July 14, 2016: Antiviral Therapy
https://www.readbyqxmd.com/read/27325324/economic-and-public-health-impacts-of-policies-restricting-access-to-hepatitis-c-treatment-for-medicaid-patients
#6
Alexis P Chidi, Cindy L Bryce, Julie M Donohue, Michael J Fine, Douglas P Landsittel, Larissa Myaskovsky, Shari S Rogal, Galen E Switzer, Allan Tsung, Kenneth J Smith
BACKGROUND: Interferon-free hepatitis C treatment regimens are effective but very costly. The cost-effectiveness, budget, and public health impacts of current Medicaid treatment policies restricting treatment to patients with advanced disease remain unknown. OBJECTIVES: To evaluate the cost-effectiveness of current Medicaid policies restricting hepatitis C treatment to patients with advanced disease compared with a strategy providing unrestricted access to hepatitis C treatment, assess the budget and public health impact of each strategy, and estimate the feasibility and long-term effects of increased access to treatment for patients with hepatitis C...
June 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27273417/hepatitis-c-drugs-top-state-medicaid-pharmaceutical-expenditures
#7
Rita Rubin
No abstract text is available yet for this article.
February 9, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27231798/access-to-new-medications-for-hepatitis-c-for-medicaid-members-a-retrospective-cohort-study
#8
Karen M Clements, Robin E Clark, Pavel Lavitas, Parag Kunte, Camilla S Graham, Elizabeth O'Connell, Kimberly Lenz, Paul Jeffrey
BACKGROUND: Sofosbuvir (SOF)- or simeprevir (SIM)-containing regimens are highly effective for treating chronic hepatitis C virus (HCV) infection. These regimens, however, are expensive. Most payers have implemented prior authorization (PA) requirements to ensure that patients who can benefit most have priority for these medications. While many Medicaid programs limit access to those with advanced disease or to members who do not have active substance use disorder (SUD), the Massachusetts Medicaid (MassHealth) Primary Care Clinician (PCC) plan does not limit access based on disease severity or presence of SUD...
June 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27062903/disparities-in-absolute-denial-of-modern-hepatitis-c-therapy%C3%A2-by%C3%A2-type-of-insurance
#9
Vincent Lo Re, Charitha Gowda, Paul N Urick, Joshua T Halladay, Amanda Binkley, Dena M Carbonari, Kathryn Battista, Cassandra Peleckis, Jody Gilmore, Jason A Roy, Jalpa A Doshi, Peter P Reese, K Rajender Reddy, Jay R Kostman
BACKGROUND & AIMS: The high costs of direct-acting antiviral (DAA) agents to treat chronic hepatitis C virus (HCV) infection have resulted in denials of treatment, but it is not clear whether patients' access to these therapies differs with their type of insurance. METHODS: We conducted a prospective cohort study among all patients who had a DAA prescription submitted between November 1, 2014 and April 30, 2015 to Burman's Specialty Pharmacy, which provides HCV pharmacy services to patients in Delaware, Maryland, New Jersey, and Pennsylvania...
July 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/26890183/hepatitis-c-screening-rate-among-underserved-adults-with-serious-mental-illness-receiving-care-in-california-community-mental-health-centers
#10
Evan Trager, Mandana Khalili, Carmen L Masson, Eric Vittinghoff, Jennifer Creasman, Christina Mangurian
Although HCV is more prevalent among people with severe mental illness (SMI; e.g., schizophrenia, bipolar disorder) than in the general population (17% vs 1%), no large previous studies have examined HCV screening in this population. In this cross-sectional study, we examined administrative data for 57 170 California Medicaid enrollees with SMI to identify prevalence and predictors of HCV screening from October 2010 through September 2011. Only 4.7% (2674 of 57 170) received HCV screening, with strongest predictors being nonpsychiatric health care utilization and comorbid substance abuse...
April 2016: American Journal of Public Health
https://www.readbyqxmd.com/read/26840452/disparate-access-to-treatment-regimens-in-chronic-hepatitis-c-patients-data-from-the-trio-network
#11
Z M Younossi, B R Bacon, D T Dieterich, S L Flamm, K Kowdley, S Milligan, N Tsai, A Nezam
Despite the clinical success in the real-world of all oral hepatitis C virus (HCV) therapy with response rates approaching that seen in the clinical trials, access has been limited by many payers with discussion of prioritization of treatment based upon AASLD guidelines. We evaluated patients in the TRIO network who were prescribed sofosbuvir (SOF)-based regimens to determine reasons for not starting treatment. Trio Health is a disease management company that works in partnership with academic medical centres, community physicians and specialty pharmacies in the United States to optimize care for HCV...
June 2016: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/26782133/the-burden-of-rehospitalization-for-patients-with-liver-cirrhosis
#12
REVIEW
Archita P Desai, Nancy Reau
Advanced liver disease is becoming more prevalent in the United States. This increase has been attributed largely to the growing epidemic of nonalcoholic fatty liver disease and an aging population infected with hepatitis C. Complications of cirrhosis are a major cause of hospital admissions and readmissions. It is important to target efforts for preventing rehospitalization toward patients with cirrhosis who are at the highest risk for readmission, such as those who have high Model for End-Stage Liver Disease scores, are at risk for fluid/electrolyte abnormalities or overt hepatic encephalopathy recurrence, and those who have comorbid conditions (e...
2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/26744994/treating-hepatitis-c-in-a-ryan-white-funded-hiv-clinic-has-the-treatment-uptake-improved-in-the-interferon-free-directly-active-antiviral-era
#13
Rebecca Cope, Thomas Glowa, Samantha Faulds, Deborah McMahon, Ramakrishna Prasad
Now that highly efficacious, interferon-free (IFN-free), direct acting antivirals (DAA) for the treatment of hepatitis C (HCV) have closed the gap between treatment and cure, identifying barriers that prevent initiation of treatment is more crucial than ever. This is a retrospective study utilizing Electronic Medical Records and Prior Authorization Records to identify HCV treatment gaps, including predictors for intention-to-treat and treatment initiation in the first 15 months of a Ryan White funded human immunodeficiency virus (HIV)/HCV co-infection clinic...
February 2016: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/26679267/evaluating-patterns-in-retention-continuation-gaps-and-re-engagement-in-hiv-care-in-a-medicaid-insured-population-2006-2012-united-states
#14
Kathy K Byrd, Melissa Furtado, Tim Bush, Lytt Gardner
We used the US-based MarketScan(®) Medicaid Multi-state Databases to determine the un-weighted proportion of publically insured persons with HIV that were retained, continued, and re-engaged in care. Persons were followed for up to 84 months. Cox proportional hazards models were conducted to determine factors associated with gaps in care. Of the 6463 HIV cases identified in 2006, 61% were retained during the first 24 months, and 53% continued in care through 78 months. Between 8% and 30% experienced a gap in care, and 59% of persons who experienced a gap in care later re-engaged in care...
2015: AIDS Care
https://www.readbyqxmd.com/read/26661399/hiv-testing-among-outpatients-with-medicaid-and-commercial-insurance
#15
Patricia M Dietz, Michelle Van Handel, Huisheng Wang, Philip J Peters, Jun Zhang, Abigail Viall, Bernard M Branson
OBJECTIVE: To assess HIV testing and factors associated with receipt of testing among persons with Medicaid and commercial insurance during 2012. METHODS: Outpatient and laboratory claims were analyzed from two databases: all Medicaid claims from six states and all claims from Medicaid health plans from four other states and a large national convenience sample of patients with commercial insurance in the United States. We excluded those aged <13 years and >64 years, enrolled <9 of the 12 months, pregnant females, and previously diagnosed with HIV...
2015: PloS One
https://www.readbyqxmd.com/read/26631494/national-health-spending-in-2014-faster-growth-driven-by-coverage-expansion-and-prescription-drug-spending
#16
Anne B Martin, Micah Hartman, Joseph Benson, Aaron Catlin
US health care spending increased 5.3 percent to $3.0 trillion in 2014. On a per capita basis, health spending was $9,523 in 2014, an increase of 4.5 percent from 2013. The share of gross domestic product devoted to health care spending was 17.5 percent, up from 17.3 percent in 2013. The faster growth in 2014 that followed five consecutive years of historically low growth was primarily due to the major coverage expansions under the Affordable Care Act, particularly for Medicaid and private health insurance, which contributed to an increase in the insured share of the population...
January 2016: Health Affairs
https://www.readbyqxmd.com/read/26312999/drug-authorization-for-sofosbuvir-ledipasvir-harvoni-for-chronic-hcv-infection-in-a-real-world-cohort-a-new-barrier-in-the-hcv-care-cascade
#17
Albert Do, Yash Mittal, AnnMarie Liapakis, Elizabeth Cohen, Hong Chau, Claudia Bertuccio, Dana Sapir, Jessica Wright, Carol Eggers, Kristine Drozd, Maria Ciarleglio, Yanhong Deng, Joseph K Lim
BACKGROUND: New treatments for hepatitis C (HCV) infection hold great promise for cure, but numerous challenges to diagnosing, establishing care, and receiving therapy exist. There are limited data on insurance authorization for these medications. MATERIALS AND METHODS: We performed a retrospective chart review of patients receiving sofosbuvir/ledipasvir (SOF/LED) from October 11-December 31, 2014 to determine rates and timing of drug authorization. We also determined predictors of approval, and those factors associated with faster decision and approval times...
2015: PloS One
https://www.readbyqxmd.com/read/26270682/access-to-costly-new-hepatitis-c-drugs-medicine-money-and-advocacy
#18
REVIEW
Stacey B Trooskin, Helen Reynolds, Jay R Kostman
Hepatitis C affects >3 million people in the United States, and often leads to end-stage liver disease or death. In 2014, several new drugs to treat hepatitic C virus received US Food and Drug Administration approval, with remarkable cure rates exceeding 90%. Medicaid, however, is rationing these drugs, and other insurers have restricted coverage due to their exorbitant costs and the large size of the population in need. These access barriers and disparities have resulted in national patient advocacy mobilization, US congressional inquiry, and legal challenges...
December 15, 2015: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/26164221/pay-for-performance-in-chronic-liver-disease
#19
REVIEW
Yamini Natarajan, Fasiha Kanwal
With the advent of the Affordable Care Act, pay-for-performance programs have become widespread in the United States and are here to stay. The Centers for Medicare and Medicaid Services started its pay-for-performance program, the Physician Quality Reporting Initiative, in 2007, and made it a permanent system, the Physician Quality Reporting System, in 2011. Although it started off as a pay-for-performance initiative, in which physicians and other health care professionals were rewarded for satisfactorily reporting on selected quality measures, it now has evolved into a penalty-based program...
November 2015: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/26121095/limited-access-to-new-hepatitis-c-virus-treatment-under-state-medicaid-programs
#20
Lauren A Canary, R Monina Klevens, Scott D Holmberg
No abstract text is available yet for this article.
August 4, 2015: Annals of Internal Medicine
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