Rhode Island HCV complications projected to continue

Rhode Island's Medicaid program covers hepatitis C virus (HCV) treatment for only the sickest patients, but the policy could undermine efforts toward statewide eradication of the disease.

Rhode Island's Medicaid program covers hepatitis C virus (HCV) treatment for only the sickest patients, but the policy could undermine efforts toward statewide eradication of the disease. Brown University researchers used statistical modeling to generate four projections—based on different insurance scenarios—related to HCV in the state. Assuming that Medicaid continues the current policy of covering only patients with stage 3 fibrosis or worse, the first model predicts the number of infected people will decrease by 2030 but that complications like cirrhosis will not. If coverage was widened to include patients with at least stage 2 fibrosis, the second model anticipates that viremic infection, cirrhosis, and liver-related deaths all would fall at least 20%. A third model, providing that all restrictions based on fibrosis are removed, calls for a similar drop in viremic infection as the second model but lesser decreases in cirrhosis and liver-related deaths. Finally, the fourth model explored how many patients would need to be treated to slash viremic infection 90% by 2030. The number would have to reach 2,000 annually from just 120 currently to achieve this goal, according to the model, which also predicted that rates of cirrhosis and liver-related deaths would sink 72.4% and 67.5%, respectively. The researchers reported the study at the International Conference on Viral Hepatitis 2016.