On World Hepatitis Day, America’s Essential Hospitals raises awareness of the importance of screening and intervention of this silent and often deadly disease that affects many members’ patients. July 28 commemorates the birthday of Baruch Blumberg, MD, DPhil, a Nobel Prize winner recognized for discovering the hepatitis B virus in 1967 and later developing the first hepatitis B vaccine. Viral hepatitis — a group of infectious diseases that includes hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E — affects more than 354 million people worldwide. In the United States, people from all walks of life are living with viral hepatitis, and most do not know they have the virus.
Chronic hepatitis C (HCV) is an important public health concern. HCV is one of the deadliest infectious diseases nationwide, according to the Centers for Disease Control and Prevention. An estimated 2.4 million people are currently living with HCV in the United States, but the actual number may be as high as 4.7 million. The rate of new infections quadrupled from 2010 to 2018 and increases every year. Infection rates are rising most among individuals ages 20 to 39, with injection drug use as the primary route of transmission.
The Key: Early Diagnosis
The World Health Organization is working to reduce new hepatitis infections across the globe by 90 percent and mortality from hepatitis by 65 percent between 2016 and 2030. Early diagnosis and referral to treatment is vital to this effort. Direct acting antivirals have been a key accelerator toward achieving this goal; however, equitable access to these medications has been a challenge, especially among racial and ethnic minorities and socioeconomically disadvantaged patient populations.
Because untreated chronic HCV can lead to liver fibrosis, cirrhosis, and liver cancer, robust screening programs and comprehensive treatment models are vital to eradicating this curable disease.
Boston Medical Center’s Screening and Treatment Program
Association member Boston Medical Center (BMC), in Boston, the largest safety net hospital in the New England region, launched its multidisciplinary cohort screening hepatitis C program in 2015. BMC created Clearway Health to share its expertise in specialty pharmacy with other hospitals, and the hospital also uses this comprehensive model to support HCV patients.
Since the launch of the HCV treatment program, BMC has treated more than 3,000 patients for hepatitis C. Although a high proportion of these treated patients had disparate social determinants of health and psychosocial factors, such as chronic homelessness and high alcohol and illicit drug use, in the immediate six months prior to starting hepatitis C treatment, 90 percent of patients have completed treatment. This model linked more patients to treatment and achieved a more than 96 percent cure rate among those with documented sustained virologic response (SVR12) viral lab studies showing there was no trace of hepatitis C in the blood after stopping treatment for 12 weeks or more.
OU Health Hepatitis C Program
Clearway Health also launched an HCV screening and treatment program at OU Health, in Oklahoma City, Okla. The state is estimated to rank second in hepatitis C prevalence with 1,820 per 100,000 residents living with HCV (HepVu, 2023). Treatment for HCV requires specialty medication, and often the path from diagnosis to receiving this type of treatment is marked with many obstacles. Specialty medications can be extremely expensive, with high co-pays or lack of health plan coverage. Many OU Health patients live in rural communities, further complicating their ability to access treatment. Clearway Health’s mission is to help health care organizations like OU Health identify opportunities to leverage their pharmacy, and, if applicable, the 340B Drug Pricing Program, to expand services to all patients in their communities, including those in rural locations.
It’s also important to ensure patients are navigating this path and getting the care they need by helping achieve prior authorizations from the patient’s health plan, finding vouchers and coupons, and ensuring patients comply with their medications to help improve overall health outcomes. The new program at OU Health includes improved testing protocols, clinical workflows, patient education, and treatment plans for the emergency department, primary care, and maternal and fetal medicine.
Raising awareness and highlighting some of the preventative programs among our members is an important way to mark World Hepatitis Day. Boston Medical Center and OU Health are just two examples of organizations leading the important work being done around the country to silence the silent killer of hepatitis C, the deadliest virus in the hepatitis family.
As vital safety nets and beacons of care in your communities, members of America’s Essential Hospitals are well-positioned to make a significant difference in the treatment of curable conditions like hepatitis. With the help of a partner like Clearway Health, developing specialty pharmacies and leveraging pharmacy care for preventative initiatives like HCV screening can significantly improve essential hospital care. To learn more about World Hepatitis Day, visit worldhepatitisday.org.