Medicare/private insurers-Can get tested for HCV without copayment

Baby Boomers Should Get Tested for HCV
A small change in rating from the US Preventive Services Task Force has incredible consequences -- allowing baby boomers to get tested for HCV without copayment....

The American Association for the Study of Liver Diseases (AASLD) applauds the US Preventive Services Task Force (USPSTF) decision of June 24, 2013 giving a "B" rating for testing baby boomers for hepatitis C virus. This seemingly small change -- from a "C" to a "B" -- in the USPSTF rating signals an incredible change in the lives of patients who have HCV and are unaware of it. A "B" rating allows for payment by Medicare and private insurers for testing with no copayment by patients.

More than 75 percent of the estimated 3 million US citizens with HCV are baby boomers. This new USPSTF "B" rating for HCV testing of baby boomers matches its rating for HCV testing among injection drug users and others at high risk. 

Earlier this year, the Centers for Disease Control and Prevention (CDC) recommended an age-based screening strategy that required a one-time test for everyone born between 1945 and 1965. The USPSTF had initially recommended a "C" rating for this birth cohort in a draft proposal, conflicting with the CDC recommendation and creating confusion in the primary care community. The change from a "C" to a "B" rating gives primary care clinicians the absolute clarity of the hepatology community -- early detection of HCV allows for the drastically greater possibility of treatment success for patients.

HCV is usually an asymptomatic disease, and three out of four of those afflicted are unaware of their infection until their liver disease is far advanced. To allow the disease to progress to the point where a patient is showing symptoms greatly increases the danger of the disease, decreases our abilities to treat these patients, and often results in the development of liver cancer, frequently requiring liver transplantation -- at best. Liver cancer is one of the few cancers increasing in frequency and has one of the highest mortality rates. The ability of a patient to be tested and treated for HCV at the earliest possible date allows him or her to avoid the disease’s progression to liver cancer.

Liver transplantation is an expensive procedure and testing for HCV with subsequent treatment is expected to decrease the number of patients who would otherwise require transplantation and provides a significant financial savings to the nation’s healthcare system. It is worthy of note that these recommendations come at a time when the treatments for hepatitis C are becoming both more effective and easier to tolerate.  The other savings is even greater -- decreasing the number of patients requiring and waiting for a liver transplantation equals saving lives. The number of livers available does not match the number of patients who currently require a transplantation, which means that patients die while on the waiting list. In 2012, there were 6,256 liver transplantations performed. As of June 7, 2013, there are 16,484 patients waiting for a suitable organ.

The CDC recommended one-time age-based screening allowing for early detection of HCV reduces the chance of progression to liver cancer, and decreases the number of patients requiring a liver transplantation. The new "B" rating by the USPSTF means that a large number of patients can be tested and successfully treated with new direct-acting antiviral drugs that have allowed the medical community to cure HCV. Ten years ago, we were not able to cure patients of HCV, but research in liver disease has led to these new drugs. Treatment is still difficult and expensive, but it is constantly improving, and we anticipate the FDA to approve numerous new drugs over the next three to five years. New drugs currently in the pipeline will allow us to increase the cure rate and decrease treatment side effects.

AASLD is a subspecialty society representing clinicians and researchers in liver disease. The work of our members has laid the foundation for the development of drugs used to treat patients with HCV. Our members are on the frontline of treating and curing these patients. This decision by the USPSTF helps us help patients.

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AASLD is the leading organization of scientists and healthcare professionals committed to preventing and curing liver disease. AASLD was founded in 1950 by a small group of leading liver specialists and has grown to an international society responsible for all aspects of hepatology.