A new CDC Vital Signs report finds that too few people diagnosed with hepatitis C are being treated, despite availability of medications capable of curing this viral infection. According to CDC’s estimates:
• Overall, less than 1 in 3 people with health insurance get direct-acting antiviral (DAA) treatment for hepatitis C within a year of diagnosis.
• Treatment is lowest among patients in state-administered Medicaid plans, with less than 1 in 4 Medicaid recipients (23%) being treated within a year of diagnosis.
o Additionally, Medicaid recipients in states that restrict access to hepatitis C treatment are 23% less likely to receive treatment than Medicaid recipients in states without restrictions.
Hepatitis C is curable with well-tolerated, oral medication. Untreated, hepatitis C can cause liver disease, liver cancer, and death. Treatment prevents illness and death, stops spread of hepatitis C, and is cost-saving. In 2019, hepatitis C contributed to the deaths of more than 14,000 people in the United States.
• For the past several years, CDC’s annual hepatitis C data have shown the highest rates of new infection among adults under 40, indicating that treating this group is critical. However, this new analysis found adults under 40 have the lowest treatment rates by age group.
o Among those under age 40, hepatitis C is most commonly spread through injection drug use.
“Everyone with hepatitis C should have access to lifesaving treatment, regardless of race, ethnicity, age or insurance status,” said CDC acting principal deputy director Debra Houry, MD, MPH. “What these data tell us is that at best, only one in three people are treated within a year of being diagnosed and we must reduce the barriers and get more people treated for hepatitis C in our country. This is critical to stop preventable deaths and prevent new infections.”
To ensure people diagnosed with hepatitis C are treated, healthcare providers, insurers, policy makers, and public health professionals should:
• Remove eligibility restrictions and preauthorization requirements that make it difficult for people with hepatitis C to access treatment that will cure the infection.
• Provide treatment where people already receive services, such as primary care offices, community clinics, syringe services programs, substance use treatment centers, and correctional facilities.
• Provide treatment in as few visits as possible.
• Expand the number of primary care providers treating hepatitis C.
“People shouldn’t have to jump over hurdles to access lifesaving, cost-effective treatment,” said Carolyn Wester, M.D., M.P.H., director of CDC’s Division of Viral Hepatitis. “Removing barriers to treatment is a critical step, as is increasing screening for hepatitis C. We estimate about 40% of people with hepatitis C in the U.S. are unaware of their infection—testing is the first step to accessing curative treatment.”
CDC recommends that everyone get tested for hepatitis C at least once in their lifetime and that people with ongoing risk factors for hepatitis C receive routine periodic testing.
• To find free hepatitis C testing in their area, people can visit gettested.cdc.gov.
• People diagnosed with hepatitis C should talk to a provider to start treatment and get cured.
• Those without insurance or who cannot afford treatment can explore pharmaceutical patient assistance programs and cost-sharing assistance programs. NASTAD.org is one resource for more information on assistance programs for hepatitis C treatment.
For more information about this report, go to www.cdc.gov/vitalsigns.