Patients with Medicaid less likely to receive HCV treatment
ORLANDO — Although diagnosed hepatitis C infection was more common among people with Medicaid insurance, the treatment rates were lower compared with people who had commercial insurance, research presented here at Digestive Disease Week suggests.
“These results were pretty much what we expected,” Jenny Griffith, PharmD, senior manager of clinical epidemiology at AbbVie, told Infectious Disease News. “We knew that people who have Medicaid insurance are typically sicker, and we expected to find the same thing in HCV. The one thing that was unexpected was that the rate of diagnosed HCV was double in the Medicaid group. One hypothesis for this is that people with Medicaid typically have a lower socioeconomic status, and according to NHANES data, there is a higher prevalence of HCV among those with a lower socioeconomic status.”
Griffith and colleagues conducted a retrospective analysis that included approximately 28 million commercial beneficiaries from Jan. 2000 to Dec. 2009 and 3.2 million Medicaid beneficiaries from July 1999 to June 2009. They evaluated the prevalence of HCV and treatment estimates, as well as comorbidities and possible contraindications to treatment.
The 10-year prevalence of HCV was 302 per 100,000 among people with commercial insurance and 663 per 100,000 among people with Medicaid. The prevalence of treatment, however, was 26.5% among patients with commercial insurance and 19.5% among Medicaid beneficiaries. Those with Medicaid had higher rates of most evaluated comorbidities, including drug abuse, ascites, COPD, depression, autoimmune disease and pregnancy. More patients on Medicaid also had possible contraindications to treatment with ribavirin and/or interferon.
“The take-home message is that if you have someone who has Medicaid insurance, they are more than likely to be sicker and have more comorbidities that will make it more difficult to treat them,” Griffith said. “The development of interferon-free treatment may increase eligibility for treatment and hopefully eliminate this gap.”
For more information:
Griffith J. #Sa1066. Presented at: Digestive Disease Week; May 18-21, 2013; Orlando.
Disclosure: Griffith is an employee of AbbVie.