Potential conflict of interest: Dr. Younossi consults for Biolex, Vertex, and Tibotee.
Article first published online: 11 FEB 2011
Copyright © 2010 American Association for the Study of Liver Diseases
Volume 53, Issue 3, pages 737–745, March 2011
How to Cite
Stepanova, M., Kanwal, F., El-Serag, H. B. and Younossi, Z. M. (2011), Insurance status and treatment candidacy of hepatitis C patients: Analysis of population-based data from the United States. Hepatology, 53: 737–745. doi: 10.1002/hep.24131
Supported in part by the Liver Outcomes Research Fund of The Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA.
- Issue published online: 2 MAR 2011
- Article first published online: 11 FEB 2011
- Accepted manuscript online: 17 DEC 2010 03:44PM EST
- Manuscript Accepted: 9 DEC 2010
- Manuscript Received: 1 SEP 2010
Successful treatment with antiviral therapy could potentially reduce morbidity and mortality in patients with hepatitis C virus (HCV) infection. However, at the population level, these benefits may be offset by a limited number of patients who have access to antiviral treatment. Using data from the National Health and Nutrition Examination Survey conducted in 2005-2008, we analyzed the health insurance status and treatment candidacy of HCV-positive (HCV+) individuals. A total of 10,582 subjects were examined; of those, 1.16% had detectable HCV RNA and were defined as HCV+. The HCV+ patients were less likely to be insured than HCV-negative individuals (61.2% versus 81.2%; P = 0.004). Among those with health insurance, HCV+ patients were less likely to have private insurance, whereas the coverage by Medicare/Medicaid and other government-sponsored plans was similar to the rest of the population. In multivariate analysis, HCV infection was an independent predictor of being uninsured even after adjustment for demographic disparity of the HCV+ cohort (odds ratio, 0.43; 95% confidence interval, 0.24-0.78). Of all HCV+ patients, 66.7% were eligible for anti-HCV treatment. However, only 54.3% of HCV+ treatment candidates had any type of insurance coverage. Finally, only 36.3% of HCV+ patients were potentially eligible for treatment and had health insurance. Conclusion: A high proportion of HCV+ patients are currently uninsured, and many have publicly funded health insurance. Among those who could be candidates for treatment, the rate of insurance coverage is even lower. These findings can have important implications for health insurance coverage of these patients under the new health care reform legislation in the United States. (HEPATOLOGY 2011)