More than 2 million U.S. adults have hepatitis C, and new infections keep rising. It spreads mostly through blood, often from injection drug use, and untreated it can cause advanced liver disease, liver cancer and death. In 2019 it contributed to more than 14,200 deaths, with higher death rates among Black (5 per 100,000) and Hispanic people (4 per 100,000) than White people (3 per 100,000).
It is also curable — in more than 95% of cases — with direct-acting antiviral (DAA) pills, available since 2014. Treating promptly prevents liver damage and further spread, and saves money by stopping the disease.
Few get treated
People who started hepatitis C treatment within 12 months of diagnosis, January 30, 2019, to October 31, 2020, by insurance. CDC.
- Even with insurance, only about 1 in 3 people began treatment within a year of diagnosis.
- People with Medicaid were 46% less likely to be treated than those with private insurance.
- Among Medicaid recipients, people of other races were up to 27% less likely to get timely treatment than White recipients.
To eliminate hepatitis C as a public health threat, more than 260,000 people would need to be treated every year. The number treated peaked in 2015 and fell to its lowest in 2020.
The barriers
The hurdles between diagnosis and treatment. CDC.
- Cost: about $90,000 per patient when DAAs arrived in 2014; much lower now, but still a barrier.
- Insurance restrictions, still common: the patient must already have liver damage (fibrosis), must be sober, must see a liver or infectious disease specialist, and the doctor needs preauthorization.
- Primary care: treatment is not a routine part of it, and too few primary care providers treat hepatitis C.
What would help
Providers, insurers, policy makers and public health should work together to:
- remove eligibility restrictions and preauthorization requirements;
- treat people where they already get care — primary care offices, community clinics, syringe services programs, substance use treatment centers and correctional facilities;
- cure people in as few visits as possible, with simplified testing and treatment;
- expand the number of primary care providers who treat it.
Everyone can get tested for hepatitis C at least once in their life — and, if positive, talk to a provider about treatment and a cure.
Sources
Based on "Too Few People Treated for Hepatitis C," CDC Vital Signs, updated September 21, 2022, and the accompanying MMWR report "Vital Signs: Hepatitis C Treatment Among Insured Adults — United States, 2019–2020"; works of the United States government in the public domain. The 2 million estimate comes from the National Health and Nutrition Examination Survey, January 2017–March 2020. Page icons and a stock photo collage are not reproduced.
Licence: CC0 1.0 (public domain) · Adapted from www.cdc.gov
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