Hepatitis C Policy Project: Priority Issues

Access to Treatment and Care

Hepatitis C can be cured, but access to treatment is still out of reach for many.


"I don't think people should be living with Hepatitis C. I think they should be cured."

Dr. Jonathan Mermin – Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

May 19, 2016 – National Hepatitis Testing Day 2016 – The White House.

Direct-acting Antiviral (DAAs) drug therapies are now available that reduce the sustained viral response (SVR) level of Hepatitis C virus in infected persons to undetectable levels, providing a CURE for Hepatitis C with minimal side effects.

American Association for the Study of Liver Disease and the Infectious Disease Society of America are the entities responsible for drafting clinical guidelines for the diagnosis and treatment of Hepatitis C. They recommend early treatment of HCV infections, including in patients who have little to no liver damage due to the infection. However, many insurers still require patients have advanced liver scarring before authorizing treatment.

Both private and public health insurers (i.e. Medicaid) have placed restrictions on access of these drugs that require that patients already have significant liver damage (scarring) before being approved for the drug.

Scarring to the liver, also known as fibrosis, is measured on a scale of F0 (no scarring) to F4 (known as Cirrhosis, a degenerative liver disease).

In November 2015, the Centers for Medicare and Medicaid Services (CMS) issued a letter to all state Medicaid Directors stating that requirements that patients have F3 or F4 liver scarring in order to receive DAA treatment constitutes an "unreasonable" restriction to access to treatment. However, according to a 2016 Harvard Law School report, 23 States still require that patients have evidence of advanced liver scarring (F3 fibrosis or higher) before authorizing treatment.

Misperceptions about Hepatitis C cause it to be an under-prioritized health issue by policy makers and the public, even though it is the most common bloodborne infection in the U.S.

The Hepatitis Policy Project profiled people with Hepatitis C from across the country to correct misconceptions about the disease and to raise awareness of the many faces of Hepatitis C in the U.S.

External Resources

Hepatitis C Profiles Paper

  • (Forthcoming)

American Association for the Study of Liver Disease – Recommendations for Testing, Managing and Treating Hepatitis C

Updated Report

Examining Hepatitis C Virus Treatment Access: A Review of Select Medicaid Fee-For-Service and Managed Care Programs

Cover of: Examining Hepatitis C Virus Treatment Access

Stigma & Hepatitis C

Anyone can get infected with Hepatitis C

Public misconception and a lack of awareness about HCV cause many with the disease to forgo seeking treatment.

  • Hepatitis C has been perceived as an infection mainly contracted through drug use or sexual transmission.
  • Fear of judgment or ridicule can deter many from disclosing their status or seeking treatment.