HIV/HCV Co-Infec0on Watch: 2017 Annual Monitoring Report · HIV/HCV Co-Infec0on Watch: 2017 Annual...
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Community Access Na0onal Network (CANN) − Na0onal Monitoring Report on HIV/HCV Co-Infec0on− Page 1 HIV/HCV Co-Infec0on Watch: 2017 Annual Monitoring Report The HIV/HCV Co-Infec0on Watch is a publica0on of the Community Access Na0onal Network (CANN). It is a pa0ent-centric informa0onal portal serving three primary groups – Pa0ents, Healthcare Providers, and AIDS Service Organiza0ons. Learn more: h"p://www.(icann.org
Transcript of HIV/HCV Co-Infec0on Watch: 2017 Annual Monitoring Report · HIV/HCV Co-Infec0on Watch: 2017 Annual...
CommunityAccessNa0onalNetwork(CANN)−Na0onalMonitoringReportonHIV/HCVCo-Infec0on−Page1
HIV/HCVCo-Infec0onWatch:2017AnnualMonitoringReport
TheHIV/HCVCo-Infec0onWatchisapublica0onoftheCommunityAccessNa0onalNetwork(CANN).Itisapa0ent-centric
informa0onalportalservingthreeprimarygroups–Pa0ents,HealthcareProviders,andAIDSServiceOrganiza0ons.
Learnmore:h"p://www.(icann.org
CommunityAccessNa0onalNetwork(CANN)−Na0onalMonitoringReportonHIV/HCVCo-Infec0on−Page2
Background• LaunchedinJanuary2015• Monthlysummaryonrelevantdataonco-infec0onofhuman
immunodeficiencyvirus(HIV)andhepa00sC(HCV)• Ini0ally,limitedfocuson:
– AIDSDrugAssistancePrograms– Medicaid– LatestNewsrelatedtoHIV/HCVandCo-Infec0on
• Subsequently,expandedfocuson:– Veterans– HarmReduc0on– RegionalTrends
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Background–What’sincluded• Overview• Findings• AIDSDrugAssistancePrograms(ADAPs)• MedicaidPrograms• VeteransPrograms• HarmReduc0onPrograms• RegionalTrends• LatestNews• ContactInforma0on• Disclaimer• Methodology• References
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ADAPHCVDAATrends:2015-2017• CoverageTrends
– January2015:• StatesofferingExpandedCoverage–7(CA,CO,HI,IA,MA,MN,NJ)• StatesofferingonlyBasicCoverage–24
– June2015:• StatesofferingExpandedCoverage–11(AZ,AR,CA,CO,HI,IA,LA,MA,MN,NJ,SD)• StatesofferingonlyBasicCoverage–24
– January2016:• StatesofferingExpandedCoverage–17(AZ,AR,CA,CO,DE,HI,IA,ME,MA,MN,NJ,OK,PA,TN,VA,WA,DC)• StatesofferingonlyBasicCoverage–18
– June2016:• StatesofferingExpandedCoverage–26(AZ,AR,CA,CO,DE,FL,GA,HI,IL,IA,LA,ME,MD,MA,MN,NE,NH,NJ,OK,PA,SD,TN,VA,
WA,DC,PR)• StatesofferingonlyBasicCoverage-16
– January2017:• StatesofferingExpandedCoverage–29(AZ,AR,CA,CO,DE,FL,GA,HI,IL,IA,LA,ME,MD,MA,MN,NE,NH,NJ,NY,OK,OR,PA,SD,
TN,VA,WA,WI,DC,PR)• StatesofferingonlyBasicCoverage–13
– August2017:• Statesofferingexpandedcoverage–33(AZ,AR,CA,CO,DE,FL,GA,HI,IL,IA,LA,ME,MD,MA,MN,MO,MT,NE,NH,NJ,NY,ND,OK,
OR,PA,SD,TN,TX,VA,WA,WI,DC,PR)• StatesofferingonlyBasicCoverage-12
– Stateshavecon0nuedtoexpandcoverageasnewer,cheaperHCVDAAshitthemarket.– Expansionhasslowedsignificantlyoverthepastyear– Harvoni,Zepa0er,andViekiraPakarethemostcovereddrugs–29,28,&26,respec0vely– OlysioandViekiraXRaretheleastcovereddrugs–19&18,respec0vely– Mavyret’sWACof$39,600for12weeks,$26,400for8weeks
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ADAPExpandedCoverage:January2015-June2015
CommunityAccessNa0onalNetwork(CANN)−Na0onalMonitoringReportonHIV/HCVCo-Infec0on−Page6
ADAPExpandedCoverage:January2016–June2016
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ADAPExpandedCoverage:January-August2017
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ADAPHCVDrugU0liza0on:January2015–August2017
7 7 78 8
10 10
13 13 13 13
15
12
14 14
16
22 2223 23 23 23 23 23 23
25 2524 24
25 25 25
6 6 6 6 6 6 67 7
8 8
10
8
1011 11
13 1314 14
16 16 16 16 16
19 1918 18
19 19 19
0
34
6 6
89
11 1112 12
1514
16 1617
23 2324 24
25 25 25 25 25
27 2728 28
29 29 29
0
2
4
6 6
89
12 12 12 12
15
1314
1516
20 2021 21
22 22 22 2223
26 26 26 26 26 26 26
0 0 0 0 0 0 0 0 0 0 0 0
6
89 9
13 13 13 1314 14 14 14
15
19 19
21 21 2122 22
0 0 0 0 0 0 0 0 0 0 0 0
5
78 8
11
1314 14
15 15 15 1516
21 21 21 21 2122 22
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9
13 1314
15
1716 16
18
20
27 27 27 2728 28 28
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
56
7
10
1213
18 1819
2021 21 21
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 45
910
11
16 16 16 16 16
18 18
0
5
10
15
20
25
30
35
ADAPHCVDrugAdop(on:January2015-August2017
Sovaldi Olysio Harovoni ViekiraPak Daklinza Technivie Zepa0er Epclusa ViekiraXR
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HCVRatesComparedtoADAPCoverage
1 Massachusetts 3.72 WestVirginia 3.43 Kentucky 2.74 Tennessee 2.65 Maine 2.36 Indiana 2.17 NewMexico 1.9
Montana 1.5NewJersey 1.5Alabama 1.4NorthCarolina 1.4Ohio 1.1Wisconsin 1.1
TenHighestRatesofHCVInfection(2015)
8
9
10
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2015-2017Trends:Medicaid• CoverageTrends
– January2015:• StatesofferingExpandedCoverage–38• StatesofferingonlyBasicCoverage–12(AK,AR,CA,CT,FL,KS,MI,NM,ND,RI,SC,TX)
– June2015:• StatesofferingExpandedCoverage–39• StatesofferingonlyBasicCoverage–11(AR,CA,CT,FL,KS,MI,NM,ND,SC,TX,WA)
– January2016:• StatesofferingExpandedCoverage–49• StatesofferingonlyBasicCoverage–2(AR,MI)
– June2016:• StatesofferingExpandedCoverage–50• StatesofferingonlyBasicCoverage–1(AR)
– August2016–August2017:• StatesofferingExpandedCoverage–51• StatesofferingonlyBasicCoverage–0
– AllstatescurrentlyofferExpandedCoverageforHCVdrugs– MedicaidprogramsquickertoadoptHCVdrugsthanADAPs– Stateswithmul0plecoverageplansarelikeliertohaveplansofferingonlyoneortwoHCVDAAs
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MedicaidExpandedCoverage:January2015–June2015
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MedicaidExpandedCoverage:January2016–June2016
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MedicaidExpandedCoverage:August2016–August2017
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MedicaidHCVDrugU0liza0on
38 38 38 39 39 39 39
44 45 45 45 45 46 46 47 46 46 46 47 48 47 46 46 46 46 46 46 47 47 47 47 47
39 39 39 40 40 40 40
44 44 43 43 43 42 42 43 42 42 43 4244 43 43 42 43 43 44 44 45 44 43 43 43
0
25 2628 28 28 28
43 44 44 44 44 45 45 46 46 46 46 46 47 47 48 48 48 48 48 48 49 49 49 49 49
0
8 8
29 29 29 29
43 44 44 44 4547 47 48 48 47 48 48 49 49 49 49 50 49 49 49 49 48 48 48 48
0 0 0 0 0 0 0 0 0
15 15
28
32
3638 37 38 39
42
4543
41 41 41 41 42 42 43 43 43 43 43
0 0 0 0 0 0 0 0 0
16 16
28
32
3739 38 38
40 4143 43 44 44 45 45 44 45 46 45 46 46 46
0 0 0 0 0 0 0 0 0 0 0 0 0 0
7
10
17
24
30
38 38
41 4143
45 46 47 48 47 47 47 47
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1517
2931
36
41 4244
47 47 48 48 48
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4
7
19
22
30
3537
4143
41 42 42 42
0
10
20
30
40
50
60
MedicaidHCVDrugAdop(on:January2015-August2017
Sovaldi Olysio Harovoni ViekiraPak Daklinza Technivie Zepa0er Epclusa ViekiraXR
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2017Trends:VeteransAffairs• CoverageTrends:
– TheReportbegancoveringVAHCVcoverageinMarch2016– CoincidedwithVAannouncementofuniversalcoverageforalleligibleVAmembers– Most-useddrugs:Epclusa(16);Harvoni(10);Zepa0er(10)– VAcon0nuestoprovidemosteffec0vetreatmentprogramingovernment-funded
healthcare
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2017Trends:HarmReduc0on• HarmReduc0onmeasuresbecomingmorepopular:
– SyringeServicesPrograms(SSPs)– ExpandedNaloxoneAccess
• CDCPublicHealthLawProgramsiteforPrescrip0onDrugsnotupdatedsinceAugust2015:– Datadifficulttotrack– Reportsoutdated
• PrimarybarrierstoHarmReduc0onMeasures:– SyringeExchange:
• Datavs.Percep0on• “Enabling”• “Condoning”• Safety/BiohazardousWaste
– MandatoryPDMPUse:• Physician/PainAdvocateopposi0on• Outdatedsoqware/interface/Userunfriendly• “Timehassle”
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2017Trends:HarmReduc0on• PrimarybarrierstoHarmReduc0onMeasures:
– DoctorShopping:• Federalblanketstatute• Repor0ng/Checkinghassle
– PhysicalExamRequirement:• Physician/PainAdvocateopposi0on• “Too0meconsuming”• “Tooonerous”• Pa0entmobility/barrierstoaccessingcare/treatment
– IDRequirementforPurchaseofPrescrip0onOpioidDrugs:• PainAdvocateopposi0on• “Burdenonpoor/minoritypa0ents”• Hardwareupdatecostsforscanning• “Governmenttracking”
– PrescriberEduca0on:• Physicianopposi0on• “Timeconsuming”
– PharmacyLock-InPrograms:• Outdated/Userunfriendlysoqware/interface• PaidAdvocateopposi0on–“Barriertoaccessingcare/treatment”
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HarmReduc0onMeasures:August2016vs.2017
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ContactInforma0onCommunityAccessNa0onalNetwork(CANN)1724FloridaAvenue,NWWashington,DC20009(202)290-2019www.0icann.orghrp://www.0icann.org/co-infec0on-watch.htmlBillArnold,President&[email protected],[email protected]
