A considerable, and rising, proportion of people who apply to their insurance companies for coverage of hepatitis C virus (HCV) medications are flat-out denied.
Publishing their findings in Open Forum Infectious Diseases, researchers conducted a prospective cohort study among 9,025 people from 45 U.S. states who were prescribed a direct-acting antiviral (DAA) regimen for HCV and had a prescription submitted between January 2015 and April 2015 to Diplomat Pharmacy Inc. This company provides hep C pharmacy services across the nation.
A total of 4,702 of the participants were covered by Medicaid, 1,821 by Medicare and 2,502 by private health insurance. A total of 3,200 (35.5 percent) of them were denied coverage for DAA treatment by their insurer, including 52.4 percent of those with private insurance, 34.5 percent of those on Medicaid and 14.7 percent of those on Medicare.
The overall rate of insurance denial increased with every progressive three-month period studied, from 27.7 percent during the first quarter to 43.8 percent during the last quarter. This trend occurred among people with all three types of insurance.
To read a press release about the study, click here.
To read the study abstract, click here.