Hepatitis C Treatment Among Commercially or Medicaid-Insured Individuals, 2014-2018
Hepatitis C Treatment Among Commercially or Medicaid-Insured Individuals, 2014-2018
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DOI：
10.1016/j.amepre.2021.05.017
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发表时间：
2021-10-19
影响因子：
5.5
通讯作者：
Thompson, William W.
中科院分区：
文献类型：
--
作者：
Harris, Aaron M.;Khan, Mohammed A.;Thompson, William W.
前言：丙型肝炎病毒感染者接受直接作用抗病毒治疗的比例尚不清楚。方法：使用从MarketScan和多州医疗补助获得的行政索赔数据估计接受丙型肝炎病毒治疗的商业或医疗补助保险患者的比例。来自标准化程序和国际疾病分类诊断代码的经过验证的算法被用于识别慢性丙型肝炎的参与者；分析(执行于2020年11月30日)仅限于在2014年1月至2018年12月的丙型肝炎病毒负荷测试索赔日期之前和之后6个月内连续参加处方药保险的成年人。使用国家药品代码的处方药声明用于丙型肝炎病毒药物。根据人口统计学和临床特征描述了接受治疗的患者的比例，并使用多变量调整的风险比和95%的保险状况来模拟与治疗的关联。结果：在慢性丙型肝炎患者中，商业保险的17,562人(69%)中的12,090人和医疗补助的27,328人中的8,112人(30%)得到了治疗。具有阿片类药物CI=0.79，0.91)、严重精神疾病(危险比=0.92，95%CI=0.87、0.98)、慢性肾病(危险比=0.75，95%CI=0.69、0.82)或HIV感染(危险比=0.74，95%CI=0.66、0.82)的商业保险患者不太可能接受治疗。有阿片类药物(风险比=0.64，95%CI=0.61，0.68)或酒精使用障碍(风险比=0.83，95%CI=0.79，0.88)的医疗补助患者不太可能接受治疗。结论：使用商业和医疗补助保险患者的行政索赔数据确定了丙型肝炎病毒治疗缺口。Am J Prev Med 2021；61(5)：716-723.由爱思唯尔公司代表《美国预防医学杂志》出版。
Introduction: The proportion of individuals infected with hepatitis C virus that receive direct-acting antiviral treatment is unclear. Methods: The proportion of commercially or Medicaid-insured patients receiving hepatitis C virus treatment was estimated using administrative claims data obtained from MarketScan and Multi-State Medicaid obtained on January 6, 2020. Validated algorithms derived from standardized procedures and International Classification of Diseases diagnosis codes were used to identify enrollees with chronic hepatitis C; analysis (performed November 30, 2020) was restricted to adults continuously enrolled with prescription drug coverage for >6 months before and after their index hepatitis C viral load test claim date from January 2014 through December 2018. Prescription drug claims using National Drug Codes were used for hepatitis C virus drugs. The proportion of treated patients by demographic and clinical characteristics was described, and associations with treatment were modeled using multivariable-adjusted hazard ratios and 95% CIs by insurance status. Results: Of patients with chronic hepatitis C, 12,090 of 17,562 (69%) with commercial insurance and 8,112 of 27,328 (30%) with Medicaid were treated. Commercially insured patients with opioid CI=0.79, 0.91), severe mental illness (hazard ratio=0.92, 95% CI=0.87, 0.98), chronic kidney disease (hazard ratio=0.75, 95% CI=0.69, 0.82), or HIV infection (hazard ratio=0.74, 95% CI=0.66, 0.82) were less likely to be treated. Medicaid patients with opioid (hazard ratio=0.64, 95% CI=0.61, 0.68) or alcohol use disorders (hazard ratio=0.83, 95% CI=0.79, 0.88) were less likely to be treated. Conclusions: Hepatitis C virus treatment gaps were identified using administrative claims data among patients with commercial and Medicaid insurance. Am J Prev Med 2021;61(5):716-723. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.