West Virginia improves access to hepatitis C treatment for state Medicaid recipients
The Center for Health Law and Policy Innovation at Harvard Law School (CHLPI) and the National Roundtable on Viral Hepatitis (NVHR) today recognize the West Virginia State Medicaid program for the removal of sobriety restrictions and prescriber restrictions on hepatitis C treatment for Medicaid recipients. Removing these requirements will ensure that people who use drugs, people who live in rural communities and other vulnerable populations most at risk of contracting the hepatitis C virus (HCV) will have better access to highly effective treatment and help eliminate HCV as a public health problem. threatens.
West Virginia’s Drug Utilization Review (DUR) Board has approved the removal of the requirement that hepatitis C treatment prescriptions must be written by or in consultation with a specialist, as well as a three-month abstinence requirement from alcohol and substance abuse. Medicaid recipients will still be required to participate in substance use testing and counseling. Historically, HCV treatment, especially for rural communities, has been delayed when hepatologists, gastroenterologists, and infectious disease specialists must be involved in prescribing treatment, despite an increasing number of primary care providers trained in prescribing and treating hepatitis C. sobriety requirements are a necessary step in achieving the complete elimination of viral hepatitis.
“We are encouraged by West Virginia Medicaid’s decision to lift two major restrictions on hepatitis C treatments for Medicaid recipients. Removing these barriers, which are primarily rooted in stigma, will directly benefit people living with hepatitis C who are often unable to access care due to their proximity to a specialist or due to their substance use.” , said Adrienne Simmons, director of programs. at NVHR. “As hepatitis C rates continue to rise alongside the current overdose crisis, state Medicaid programs must protect their most vulnerable populations and provide broad access to lifesaving treatments.”
West Virginia has seen a sharp increase in hepatitis C rates in recent years. The highest rate of new chronic hepatitis C cases reported in 2019 was in West Virginia, at a rate of 201 cases per 100,000 population according to the Centers for Disease Control and Prevention (CDC). West Virginia also experienced significantly high rates of opioid use and death rates. The state had the highest death rate caused by a drug overdose from any state each year between 2014 and 2020.
“The lifting of restrictions on prescribers and sobriety by West Virginia Medicaid brings us one step closer to bringing the state out of the dark ages when it comes to access to HCV treatment,” said Leigh Brooks, nurse practitioner family and medical director of Bluestone Primary Care in Princeton, West Virginia. “There should be no discrimination in curing someone with HCV; requiring a person with HCV to undergo a drug test before treating them makes no sense. It is heartening to see West Virginia joining a growing list of states to facilitate the treatment and cure of this widespread disease.
Hepatitis C is the deadliest blood-borne infectious disease in the United States, affecting an estimated 2.4 million Americans, according to the CDC. Hepatitis C cases have been increasing since 2010 due to the current opioid crisis. National trends indicate an increase incidence of hepatitis C caseswhile hepatitis C treatment rates alarmingly reduced between 2014 and 2020. Hepatitis C disproportionately impacts communities of color, people who use drugs, rural communities, people who are incarcerated and others who have historically faced inequities in access to health care. Complications of hepatitis C can be life-threatening if left untreated, but direct-acting antivirals (DAAs) offer an almost 100% cure rate within 8-12 weeks of treatment. Yet barriers to this treatment persist across the country.
“West Virginia’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 West Virginia Medicaid for expanding access to hepatitis C treatment for Medicaid recipients, which will help save lives and stem the tide of hepatitis C.”
For more information on barriers to accessing hepatitis C treatment, please visit www.stateofhepc.org.
About Harvard Law School’s Center for Health Law and Policy Innovation (CHLPI)
Harvard Law School’s Center for Health Law and Policy Innovation (CHLPI) advocates for legal, regulatory, and policy reforms to improve the health of marginalized populations, with a focus on the needs of low-income people living with chronic conditions and disabilities. CHLPI strives to expand access to high quality health care; reduce health disparities; build community advocacy capacity; and to promote more equitable and efficient health care systems. The CHLPI is a clinical teaching program at Harvard Law School and coaches students to become competent, innovative, and thoughtful practitioners and leaders in health and public health law and policy. For more information, visit www.chlpi.org.
About the National Roundtable on Viral Hepatitis (NVHR)
The National Roundtable on Viral Hepatitis, an initiative of HEP, is a national coalition fighting for an equitable world without viral hepatitis. NVHR seeks to eliminate viral hepatitis in the United States and improve the lives of those affected through advocacy, education, and support for national, state, and local partners. For more information, visit www.nvhr.org.