Arizona increases access to hepatitis C treatment for state Medicaid recipients, but barriers remain
Harvard Law School’s Center for Health Law and Policy Innovation (CHLPI) and the National Viral Hepatitis Roundtable (NVHR) today recognize the State of Arizona’s Medicaid program for the removal of sobriety restrictions on the treatment of hepatitis C for Medicaid recipients. Eliminating sobriety requirements will ensure that people who use drugs and who are most at risk of contracting the hepatitis C virus (HCV) will have better access to highly effective treatment and help eliminate HCV by as a threat to public health.
Arizona Medicaid made the decision to remove the requirement to abstain from drugs and alcohol for at least 3 months to receive treatment for hepatitis C at the end of 2021. Arizona joins 18 other states that have eased their restrictions of sobriety since 2017. However, some restrictions in Arizona remain to fully realize access to HCV treatment, including prescriber requirements.
In Arizona, fee-for-service (FFS) and six managed care organizations (MCOs) require that a prescription be written by or in consultation with a gastroenterologist, hepatologist, or infectious disease physician. The CHLPI and NVHR have submitted comments to the Arizona Health Care Cost Containment System (AHCCCS) encouraging the Pharmacy & Therapeutics Committee to remove all restrictions on prescribers, as a wide range of lay providers can prescribe safely and effective treatment for HCV. Removing restrictions on prescribers will be necessary to achieve complete elimination of viral hepatitis.
In Arizona, reported and estimated cases of acute HCV infection have increased each year since 2012, according to the Centers for Disease Control and Prevention (CDC). HCV is one of the most commonly reported infectious diseases in Arizona and disproportionately affects people who have a history of drug use and/or incarceration, according to the state’s latest report. viral hepatitis report. Removing restrictions on prescribers and ensuring parity between FFSs and MCOs will help stem the tide of hepatitis C in Arizona.
“The removal of sobriety restrictions in Arizona Medicaid is a great example of people who use drugs standing up for themselves, being supported and winning,” said Chris Abert, founder of Southwest Recovery Alliance. “And not only is this a victory for people who have been denied life-saving treatment, it’s a victory for public health as a whole. Because the health of drug users is public health.”
“We are thrilled to see sobriety restrictions on hepatitis C treatment for Medicaid recipients lifted in Arizona. It is critical that other states follow Arizona’s lead in lifting these restrictions, which are primarily rooted in stigma, to ensure that the most vulnerable populations can access life-saving treatment for hepatitis C,” said Adrienne Simmons, Director of Programs at NVHR. “We now encourage the Pharmacy and Therapeutics Committee of AHCCCS to remove burdensome prescriber restrictions on access to hepatitis C treatment for Medicaid recipients, which will help Arizona further realize the possibility of eliminating hepatitis C.”
Cases of hepatitis C, a viral infection that causes liver inflammation and is a leading cause of liver disease, have been increasing since 2010 due to the current opioid crisis. Complications of hepatitis C can be fatal if left untreated, but innovative direct-acting antiviral drugs can cure most people in 8 to 12 weeks. Yet barriers to this treatment persist across the country.
“Arizona’s discriminatory restrictions were harming thousands of people living with hepatitis C and creating lingering health consequences despite the availability of a cure,” said Robert Greenwald, clinical professor of law at Harvard. Law School and Director of the CHLPI Faculty. “We commend Arizona for joining the many Medicaid programs across the country that have improved access to lifesaving hepatitis C treatments.”