Source: Center for Improving Value in Health Care (CIVHC)
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DENVER – May 18, 2016 – A new report from the Center for Improving Value in Health Care (CIVHC) finds that most Coloradans with the Hepatitis C virus are not being treated for what can be a serious, long-term chronic liver infection. The analysis also found that in spite of availability of new revolutionary drugs, 89 percent of Coloradans in with Hepatitis C did not receive any treatment for their condition.
The study analyzed claims data from the Colorado All Payer Claims Database (CO APCD) for the commercially insured (excluding those on self-insured plans), Medicaid and Medicare Advantage members in 2013 and 2014.
Until recently, the most common treatment for Hepatitis C had significant side effects and was difficult for many patients to tolerate. At the end of 2013, oral medications with fewer serious side effects became available that not only treat but eliminate symptoms. Sovaldi was the first medication to hit the market, and later in 2014, Harvoni became available as the first drug that could eliminate symptoms without the need for a second drug. Both Solvadi and Harvoni have made headlines for being among the most expensive drugs sold in America.
Hepatitis C is commonly associated with the baby boomer generation, and consistent with national trends, the analysis found that the majority of Coloradans with Hepatitis C are between the ages of 51 to 71. The largest portion of the population with the condition live in urban parts of Colorado, and slightly more men (54 percent) have been diagnosed than women (46 percent). Since the virus often has few noticeable symptoms, the Centers for Disease Control and Prevention (CDC) recommends that everyone in the United States born between 1945 and 1965 be tested. It is estimated that up to three out of four persons with the virus do not know they are infected.
“When we looked at claims information for insured Coloradans, we were surprised to learn how many patients are not getting treatment for this serious, potentially life-threatening infection,” said Ana English, CIVHC CEO and president. “Revolutionary treatment options are now available that can essentially cure those infected with Hepatitis C, so it’s incumbent upon us as a state to increase access to affordable treatment.”
In 2013, four percent of Coloradans received medication for Hepatitis C prior to the release of the new treatments. When the new drugs entered the marketplace, the number of Coloradans receiving drug treatment increased substantially, with seven percent on the new treatment and four percent remaining on the old regimen. With only 11 percent of the affected population on medication, nearly 90 percent of Coloradans with the condition are still not receiving any treatment as part of their health care insurance benefit.
The analysis does not reflect Coloradans who may have received medication but paid out-of-pocket or received treatment through a financial assistance program.
“In the coming months, CIVHC and partners across Colorado will continue to investigate Hepatitis C and treatment patterns, including regional trends and breakouts by insurance type. These explorations will help us understand why some patients are receiving new treatments and why some are not, plus determine the cost implications and impact on the health of Coloradans,” English said.
CIVHC (civhc.org) is a nonprofit, nonpartisan organization that helps Colorado identify ways to pay for, deliver and select high value health care. Through the pioneering Colorado All Payer Claims Database, we offer the state’s most comprehensive health care cost, quality and utilization claims data. We unlock information and provide tools and insights that guide meaningful action to improve health, enhance quality and lower cost. Bringing together a broad spectrum of organizations and individuals to design and drive collective change, CIVHC is devoted to a single cause: advancing an exceptional health care system for Colorado.