VA Extends New Hepatitis C Drugs to All Veterans in Its Health System

Graham, J.

doi:10.1001/jama.2016.8669

Cited by 12 publications

(14 citation statements)

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“…First, in January 2016, the US Congress approved $1.5 billion for HCV DAA costs in the VA in FY 2016, doubling the funding from FY 2015 . Second, the VA was able to purchase LDV/SOF and PrOD in 2016 at approximately half the price paid in 2015 . Third, the FDA approval of additional antiviral agents including daclatasvir (approved 24 July 2015), elbasvir/grazoprevir (approved 28 January16) and velpatasvir/sofusbuvir (approved 28 June 2016) will lead to increased treatment and cure rates, particularly for genotype 2 and 3‐infected patients who have fewer treatment options and lower SVR rates than genotype 1‐infected patients.…”

Section: Discussionmentioning

confidence: 99%

“…30 Through the Specialty Care Access Network-Extension for Community Healthcare Outcomes (SCAN-ECHO) program, which allows physicians, nurses and pharmacists to get teaching and feedback through videoconferencing from HCV experts, median time from diagnosis to treatment has decreased from more than 2 years to 6 months. 31 Finally, the VA used existing electronic databases to identify and coordinate care for HCV-infected Veterans, employed aggressive screening practises for HCV and encouraged local facilities to set ambitious treatment goals. These goals were facilitated by a national integrated hepatitis C program, which oversees and supports dedicated hepatitis C teams at every VA facility.…”

Section: Impact Of Funding Availability On Antiviral Treatment Ratesmentioning

confidence: 99%

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Transformation of hepatitis C antiviral treatment in a national healthcare system following the introduction of direct antiviral agents

Moon

Green

Berry

et al. 2017

Aliment Pharmacol Ther

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Background Well-tolerated, highly-effective direct antiviral agents (DAAs) for hepatitis C virus (HCV) were recently introduced. Their utilization has been limited by high cost and low access to care. Aim We aimed to describe the impact of DAAs on HCV treatment and cure rates. Methods We identified all HCV antiviral treatment regimens initiated from 1/1/1999 to 12/31/2015 (n=105,369) in the Veterans Affairs (VA) national healthcare system of the United States and determined if they resulted in sustained virologic response (SVR). Results HCV antiviral treatment rates were low (1,981-6,679 treatments/year) in the interferon era (1999-2010). The introduction of simeprevir and sofosbuvir in 2013 and ledipasvir/sofosbuvir and paritaprevir/ombitasvir/ritonavir/dasabuvir in 2014 were followed by dramatic increases in annual treatment rates to 9,180 in 2014 and 31,028 in 2015. The number of patients achieving SVR was 1,313 in 2010, the last year of the interferon era and increased 5.6-fold to 7,377 in 2014 and 21-fold to 28,084 in 2015. The proportion of treated patients who achieved SVR increased from 19.2% in 1999 and 36.0% in 2010 to 90.5% in 2015. Within 2015, monthly treatment rates ranged from 727 in July to 6,868 in September correlating with the availability of funds for DAAs. Conclusion DAAs resulted in a 21-fold increase in the number of patients achieving HCV cure. Treatment rates in 2015 were limited primarily by the availability of funds. Further increases in funding and cost reductions of DAAs occurring in 2016 suggest that the VA could cure the majority of HCV-infected Veterans in VA care within the next few years.

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Section: Discussionmentioning

confidence: 99%

Section: Impact Of Funding Availability On Antiviral Treatment Ratesmentioning

confidence: 99%

Transformation of hepatitis C antiviral treatment in a national healthcare system following the introduction of direct antiviral agents

Moon

Green

Berry

et al. 2017

Aliment Pharmacol Ther

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“…Veterans who served during the Vietnam War era (1961)(1962)(1963)(1964)(1965)(1966)(1967)(1968)(1969)(1970)(1971)(1972)(1973)(1974)(1975) 16 VA has committed to treating all Veterans enrolled in VA care for HCV and h as undertaken systems redesign efforts to reach out to Veterans with HCV infection who are more difficult to engage in care and connect them to treatment services. VA is also partnering with community providers through the Choice Program to offer care in the community where available and is partnering with Veterans Service Organizations to promote testing and treatment among Veterans not currently enrolled in or seeking care in the VA system.…”

Section: Veteransmentioning

confidence: 99%

“…16,17 • The federal ban on using federal funds to support syringe services programs (SSPs) was lifted in 2015 and jurisdictions across the United States are working to expand and implement these programs.…”

mentioning

confidence: 99%

Measuring Adherence to Hepatitis C Direct-Acting Antiviral Medications: Using the VAS in an HCV Treatment Clinic

Burton

Voluse

Patel

et al. 2018

Southern Medical Journal

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“…As veterans treated with the new medication confide in their peers (Phillips & Barnes, ), the old “horror stories” of INF‐RBV (Groessl et al, 2008; Zuchowski et al, ) may become a thing of the past. As the VA provides greater access to the new medications (Graham, ), and more veterans seek and receive treatment (Moon et al, ), the prevailing representation may become that HCV is a controllable illness, perhaps making treatment more feasible.…”

Section: The Common‐sense Modelmentioning

confidence: 99%

The role of stigma and trauma in hepatitis C virus treatment in veterans: Applying the common‐sense model

Garvey

Jones

2019

Public Health Nursing

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Hepatitis C Virus (HCV), a blood borne pathogen capable of causing severe liver disease, disproportionately affects veterans in the United States. While there are antiviral medications to treat HCV, stigma and trauma in this population may lead to avoidance of care. Those veterans who do undergo treatment have certain illness representations about HCV and its treatment. They undergo treatment even while facing stigma and trauma. The Common‐Sense Model may be useful in elucidating how such representations, when matched to an appropriate illness prototype, may inform an action plan of how to respond to HCV. An exploration of the illness representations among veterans with HCV, and the effects of stigma and trauma on these representations, may help to explain how they exercise the choice to undergo treatment and may inform interventions to encourage treatment in veterans who have yet to do so.

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VA Extends New Hepatitis C Drugs to All Veterans in Its Health System

Cited by 12 publications

References 0 publications

Transformation of hepatitis C antiviral treatment in a national healthcare system following the introduction of direct antiviral agents

Transformation of hepatitis C antiviral treatment in a national healthcare system following the introduction of direct antiviral agents

Measuring Adherence to Hepatitis C Direct-Acting Antiviral Medications: Using the VAS in an HCV Treatment Clinic

The role of stigma and trauma in hepatitis C virus treatment in veterans: Applying the common‐sense model

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