Start Date

5-3-2024 9:10 AM

End Date

5-3-2024 11:00 AM

Description

Background

  • Over the past decade there has been a paradigm shift in solid organ transplantation with the use of Hepatitis C (HCV) positive donor organs for HCV negative recipients.
  • This evaluation looks through the lens of insurance approval for direct acting antivirals (DAA) and the process needed for obtaining and ensuring affordability of these medications.
  • While the AASLD/IDSA guidelines recommend early initiation of pangenotypic DAA therapy after organ transplant without the need to confirm recipient viral replication many centers often initiate the DAA approval process after viremia is detected due to insurance barriers.1
  • The process for obtaining insurance approval can be both time and resource intensive and can often delay the initiation of therapy with the potential for untreated HCV related complications.

Keywords

transplant, insurance, prior authorization, hepatitis C

Comments

Presented at the 2024 Jefferson Health Equity and Quality Improvement (HEQI) Summit.

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May 3rd, 9:10 AM May 3rd, 11:00 AM

Medication Access Barriers to Hepatitis C Anti-Viral Therapy following Transplantation of Hepatitis C Positive Donors into Hepatitis C Negative Recipients

Background

  • Over the past decade there has been a paradigm shift in solid organ transplantation with the use of Hepatitis C (HCV) positive donor organs for HCV negative recipients.
  • This evaluation looks through the lens of insurance approval for direct acting antivirals (DAA) and the process needed for obtaining and ensuring affordability of these medications.
  • While the AASLD/IDSA guidelines recommend early initiation of pangenotypic DAA therapy after organ transplant without the need to confirm recipient viral replication many centers often initiate the DAA approval process after viremia is detected due to insurance barriers.1
  • The process for obtaining insurance approval can be both time and resource intensive and can often delay the initiation of therapy with the potential for untreated HCV related complications.