ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2016
Disparities in Absolute Denial of Modern Hepatitis C Therapy by Type of Insurance.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
77 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The association of direct-acting antiviral therapy with health care utilization and costs in patients with chronic hepatitis C virus infection: A systematic review of real-world studies in the United States.Journal of managed care & specialty pharmacy · 2025Pooled it
- Regional differences in treatment rates for patients with chronic hepatitis C infection: Systematic review and meta-analysis.PloS one · 2017Pooled it
- A randomized, proof-of-concept clinical trial on repurposing chlorcyclizine for the treatment of chronic hepatitis C.Antiviral research · 2019Trial
- U.S. health plan coverage of Neuromuscular Disease Therapies: An assessment of policy availability and restrictions.Journal of neuromuscular diseases · 2026Article
- Albumin prevents kidney injury but is underutilized in a cohort of patients undergoing large-volume paracentesis.Hepatology communications · 2025Article
- Trends in Hepatitis C and Hepatitis B Deaths Identify Successes and Disparities, Alameda County, CA, 2005 - 2022.Gastroenterology research · 2025Article
- Medicaid Policy and Hepatitis C Treatment Among Rural People Who Use Drugs.Medical care · 2025Article
- Social Determinants of Health and Insurance Claim Denials for Preventive Care.JAMA network open · 2024Article
- The State of Hepatitis C Elimination from the Front Lines: A Qualitative Study of Provider-Perceived Gaps to Treatment Initiation.Journal of general internal medicine · 2024Article
- Bridging the gap: Addressing disparities in hepatitis C screening, access to care, and treatment outcomes.World journal of hepatology · 2024Review
- Hepatitis C virus care cascade among people who inject drugs in puerto rico: Minimal HCV treatment and substantial barriers to HCV care.Drug and alcohol dependence reports · 2023Article
- Health Insurance and Initiation of Direct-Acting Antivirals for Hepatitis C in US Women With Human Immunodeficiency Virus.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Association Between Alcohol Use Disorder and Receipt of Direct-Acting Antiviral Hepatitis C Virus Treatment.JAMA network open · 2022Article
- Rapid Treatment Initiation for Hepatitis C in Young People Who Inject Drugs: The Seek, Test, and Rapid Treatment Randomized Trial.Open forum infectious diseases · 2022Article
- Association of Referral Source and Substance Use with Hepatitis C Virus Outcomes at a Southern Academic Medical Center.Southern medical journal · 2022Article
- Predictors of linkage to hepatitis C virus care among people living with HIV with hepatitis C infection and the impact of loss to HIV follow-up.Health science reports · 2022Article
- Impact of Medicaid Expansion on Liver-Related Mortality.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022Article
- Healthcare resource utilization in Hepatitis C-infected patients completing eight versus twelve weeks of treatment: A retrospective cohort study.Frontiers in gastroenterology (Lausanne, Switzerland) · 2022Article
- Decreases in Hepatitis C Testing and Treatment During the COVID-19 Pandemic.American journal of preventive medicine · 2021Article
- Impact of Removing Medicaid Fee-for-Service Hepatitis C Virus (HCV) Treatment Restrictions on HCV Provider Experience with Medicaid Managed Care Organizations in New York City.Journal of urban health : bulletin of the New York Academy of Medicine · 2021Article
17 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
Abstract
BACKGROUND &
aimsThe high costs of direct-acting antiviral (DAA) agents to treat chronic hepatitis C virus (HCV) infection have resulted in denials of treatment, but it is not clear whether patients' access to these therapies differs with their type of insurance.
methodsWe conducted a prospective cohort study among all patients who had a DAA prescription submitted between November 1, 2014 and April 30, 2015 to Burman's Specialty Pharmacy, which provides HCV pharmacy services to patients in Delaware, Maryland, New Jersey, and Pennsylvania. We determined the incidence of absolute denial of DAA prescription, defined as a lack of approval of a prescription fill by the insurer, according to type of insurance (US Medicaid, US Medicare, or commercial insurance). Multivariable Poisson regression was used to estimate adjusted relative risks of absolute denial associated with patient characteristics.
resultsAmong 2321 patients prescribed a DAA regimen (503 covered by Medicaid, 795 covered by Medicare, and 1023 covered by commercial insurance), 377 (16.2%) received an absolute denial. The most common reasons for absolute denial were insufficient information to assess medical need (134 [35.5%]) and lack of medical necessity (132 [35.0%]). A higher proportion of patients covered by Medicaid received an absolute denial (233 [46.3%]) than those covered by Medicare (40 [5.0%]; P < .001) or commercial insurance (104 [10.2%]; P < .001). Medicaid insurance (adjusted relative risk, 4.14; 95% confidence interval, 3.38-5.08) and absence of cirrhosis (adjusted relative risk, 1.96; 95% confidence interval, 1.53-2.50) were associated with absolute denial.
conclusionsThere are significant disparities in access to DAA-based treatments for HCV infection among patients with different types of insurance. Nearly half of Medicaid beneficiaries in Delaware, Maryland, New Jersey, and Pennsylvania were denied access to these drugs for chronic HCV infection.
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Registered trials
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