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At a time when curative treatment is available for hepatitis C (HCV), some state Medicaid programs are instituting harmful barriers to the new HCV treatment, including limiting the availability of physicians to treat this growing epidemic by restricting infectious diseases and HIV physicians from prescribing life-saving medications. An estimated 4 million people in the U.S. are infected with HCV and at least 20,000 new infections occur every year.
The Infectious Diseases Society of America (IDSA) and HIV Medicine Association (HIVMA) urge the Centers for Medicare and Medicaid Services (CMS) to carefully review all state restrictions on the new HCV treatment to ensure they are evidenced-based and to bar states from excluding ID and HIV physicians from prescribing the new HCV treatments.
“ID and HIV specialists are on the front lines of hepatitis C research and treatment. Our background in understanding this disease and the therapies approved to treat it give us a level of expertise that may not be available via other medical specialties,” says Barbara Murray, MD, president of IDSA. “It is estimated that half of patients infected with hepatitis C are unaware of their status. As increased emphasis on testing and diagnosis is realized, we may be faced with a shortage of physicians available to treat and care for these patients. Now is not the time to place restrictions on the availability of physicians, especially those with some of the most experience treating this disease.”
“As many as 25 percent of hepatitis C patients are co-infected with HIV. As an ID and HIV specialist, I am intimately familiar with the mechanisms of action of these advanced therapies, which are similar to those used to treat HIV,” says Joel Gallant, MD, chair of HIVMA. “Due to their understanding of these therapies, my non-ID trained colleagues who are HIV specialists are also well suited to treat co-infected patients and to handle complications that may arise from therapy. Restricting us from providing this care does a great disservice to our patients and to public health.”
Recognizing the importance of expanding clinical expertise on hepatitis C, IDSA and the American Association for the Study of Liver Diseases (AASLD), in collaboration with IAS-USA, have led the way in providing timely clinical guidance for the therapy of hepatitis C via www.hcvguidelines.org. This website is a living document that provides timely updates to assist prescribers on treating this patient population. The guidance finds that all individuals with chronic HCV will benefit from treatment, but offers recommendations for prioritization when necessary.