Recent data released by Trio Health show that the prevalence of hepatitis C drug patients diagnosed with Hepatitis C but not started on curative drugs, such as Harvoni (ledipasvir/sofosbuvir; Gilead) and Zepatier (elbasvir/grazoprevir; Merck), more than tripled between 2014 and 2016—signaling that payers continue to deny coverage despite increased marketplace competition and availability of discounts.
“There are no other disease states that I’m aware of where curative therapies are increasingly withheld from patients who are covered by commercial insurance plans, Medicaid or Medicare,” Nezam Afdhal, MD, professor of medicine, Harvard University, and chairman of Trio Health’s Scientific Steering Committee, said in a press release.
According to the data, although the number of treated patients continually decreases, the total number of patients seeking treatment for their condition continues to grow each year. On average, as of last September, 37% of patients who showed little-to-moderate traces of the disease were denied—a steady increase from 27% in October 2015. Likewise, 24% of those with advanced forms of hepatitis C were also denied—an increase from 15% during 2015. Overall, non-starts increased from 8% in 2014 to over 30% in 2016.