ArticleJAMA health forum2024
Changes in Use of Hepatitis C Direct-Acting Antivirals After Access Restrictions Were Eased by State Medicaid Programs.
Article in JAMA health forum, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- 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
- Cost-Effectiveness of Pharmacologic Therapies for Metabolic Dysfunction-Associated Steatohepatitis With Significant Fibrosis in the United States.Diabetes, obesity & metabolism · 2026Article
- Missed opportunities for Hepatitis C Virus screening and care among persons hospitalized for injection-related infections.Drug and alcohol dependence · 2026Article
- Hepatocellular Carcinoma Survival in People With and Without HIV in the United States, 2001-2019.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Improving access to direct acting antivirals via a multimodal integrated care program in an addiction medicine clinic.The American journal on addictions · 2026Article
- Health care costs associated with disease progression of untreated chronic hepatitis C in the United States.Journal of managed care & specialty pharmacy · 2026Observational
- Article
- Changes in Medication Use During Medicaid Continuous Enrollment and Unwinding.JAMA health forum · 2026Article
- Clinical and demographic characteristics of participants in a hepatitis C treatment trial in rural Kentucky: How policies around treatment access may impact elimination efforts in the United States.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- What should infectious diseases clinicians know about pharmacy benefit managers and their impact on our patients?Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Review
- Testing and Linkage to Hepatitis C Care From Alternative-to-Incarceration Programs: The Right Place? The Right Time?Journal of correctional health care : the official journal of the National Commission on Correctional Health Care · 2025Article
- Building a Low-Threshold Model for HCV Diagnosis and Treatment Among Formerly Incarcerated Patients in Alabama.Journal of general internal medicine · 2025Article
- Racial and Sociodemographic Disparities in Hepatitis C Treatment at an Urban Academic Medical Center, 2018-2023.Open forum infectious diseases · 2025Article
- Prevalence and Correlates of Hepatitis C Viremia Among People With Human Immunodeficiency Virus in the Direct-Acting Antiviral Era.Open forum infectious diseases · 2025Article
- Review
- Medicaid Expansion and Restriction Policies for Hepatitis C Treatment.JAMA network open · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Direct-acting antivirals (DAAs) are safe and highly effective for curing hepatitis C virus (HCV) infection, but their high cost led certain state Medicaid programs to impose coverage restrictions. Since 2015, many of these restrictions have been lifted voluntarily in response to advocacy or because of litigation. Objective: To estimate how the prescribing of DAAs to Medicaid patients changed after states eased access restrictions. Design, Setting, and Participants: This modified difference-in-differences analysis of 39 state Medicaid programs included Medicaid beneficiaries who were prescribed a DAA from January 1, 2015, to December 31, 2019. DAA coverage restrictions were measured based on a series of cross-sectional assessments performed from 2014 through 2022 by the US National Viral Hepatitis Roundtable and the Center for Health Law and Policy Innovation. Exposure: Calendar quarter when states eased or eliminated 3 types of DAA coverage restrictions: limiting treatment to patients with severe liver disease, restricting use among patients with active substance use, and requiring prescriptions to be written by or in consultation with specialists. States with none of these restrictions at baseline were excluded. Main Outcomes and Measures: Quarterly number of HCV DAA treatment courses per 100 000 Medicaid beneficiaries. Results: Of 39 states, 7 (18%) eliminated coverage restrictions, 25 (64%) eased restrictions, and 7 (18%) maintained the same restrictions from 2015 to 2019. During this period, the average quarterly use of DAAs increased from 669 to 3601 treatment courses per 100 000 Medicaid beneficiaries. After states eased or eliminated restrictions, the use of DAAs increased by 966 (95% CI, 409-1523) treatment courses per 100 000 Medicaid beneficiaries each quarter compared with states that did not ease or eliminate restrictions. Conclusions and Relevance: The results of this study suggest that there was greater use of DAAs after states relaxed coverage restrictions related to liver disease severity, sobriety, or prescriber specialty. Further reductions or elimination of these rules may improve access to a highly effective public health intervention for patients with HCV.
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