Few insured individuals with hepatitis C virus (HCV) receive timely direct-acting antiviral (DAA) treatment, according to research published in Morbidity and Mortality Weekly Report. Carolyn Wester, MD, and colleagues constructed a cohort of adults aged 18-69 with HCV to examine initiation of DAA treatment. The prevalence of DAA treatment initiation within 360 days of the first positive HCV RNA test was 23% among those with Medicaid, 28% among those with Medicare, and 35% among those with private insurance. Among treated patients, treatment was initiated within 180 days of diagnosis in 75% of patients with Medicaid, 77% of patients with Medicare, and 84% of patients with private insurance. Compared with those with private insurance, those with Medicaid and Medicare had lower adjusted odds of treatment initiation (adjusted ORs, 0.54 and 0.62, respectively). The odds of treatment initiation were lower for persons in states with Medicaid treatment restrictions (adjusted OR, 0.77) and among those whose race was coded as Black or other versus White (adjusted ORs, 0.93 and 0.73, respectively).
