According to the CDC, Hepatitis C virus (HCV) is the most common chronic bloodborne infection in the United States. Substance users, who engage in high-risk behaviors, are particularly vulnerable to HCV infection. However, many are unable to access treatment due to a number of barriers. Recent advances in drug efficacy and tolerability have addressed some of these barriers to HCV treatment by reducing treatment duration, eliminating burdensome side effects associated with interferon-based therapies, and reducing the numbers of pills a patient must ingest. However, other barriers also include a lack of health insurance within high-risk populations and failure of medical and substance use treatment systems to effectively coordinate care.
A recent analysis, co-authored by a NIDA grantee from Rockefeller University, explains how the Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act may help address some of these barriers to impact HCV treatment. Specifically these health reform laws promote integration of medical and behavioral health care; expand healthcare eligibility and coverage, including establishment of parity between medical and substance use disorder treatments; and provide incentives to provide quality, cost-effective management of chronic disease conditions. The authors make a number of recommendations on how federal agencies can work together to provide a framework to enhance implementation of ACA initiatives including:
- Establishing a national system for HCV surveillance
- Enhance primary care providers’ capacity to screen and treat HCV
- Develop and test best practices for integrated behavioral and medical care for HCV
- Improve primary care and substance abuse treatment integration
- Expand primary and secondary HCV prevention efforts
- Assess costs related to HCV
By capitalizing upon provisions within the ACA, patients may have increased access to quality care that promotes increased screening, diagnosis, and treatment adherence. This could eventually reduce HCV-associated liver disease and mortality, leading to significant savings in health care costs associated with chronic HCV infection.
Article:
A Window of Opportunity: Maximizing the Effectiveness of New HCV Regimens in the United States With the Expansion of the Affordable Care Act; Sean J. Haley, and Mary Jeanne Kreek; American Journal of Public Health; Published Online: January 20, 2015.
http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2014.302327