According to the Polaris Observatory estimates just over half of
people with hepatitis C in the United States are aware of their
infection. Although rates of diagnosis are high in New York state (81%)
and California (71%), other states are doing less well, and the United
States is also experiencing a sharp increase in new hepatitis C
infections in young adults and adolescents as a result of sharing of
In 2015, the US treated around 256,000
people and some 230,000 in 2016. Polaris’s latest projections suggest
that without new initiatives to boost treatment and diagnosis rates the
annual number treated across the US will fall to just 130,000 per year
by 2020. To reach the World Health Organization 2030 elimination target, treatment levels must
be sustained at 250,000 per year leading up to 2030. The US is also
unlikely to meet the targets set out in its own national plan, some of
which are even more ambitious – such as a 60% fall in both hepatitis B
and hepatitis C new infections by 2020.
In two thirds
of states, treatment on Medicaid programmes has been restricted to people
with advanced disease, preventing treatment access for those without
private insurance. However, the outlook is not entirely bleak – recent
developments have meant the approval of new and cheaper hepatitis C
drugs, which can be used to treat all types of the virus (genotypes
1-6), requiring just 8 weeks of treatment to achieve cure.
These lower prices are allowing states such as Delaware, which
previously restricted treatment to the sickest people, to open up
Medicaid coverage to all people with hepatitis C from January 2018.
Delaware joins 16 other states (including Alaska and Georgia) that will
open up restrictions (or never had them).
At the recent Liver Meeting in Washington, DC all states
and Puerto Rico were graded on how easy it is to obtain Medicaid
treatment for hepatitis C. States receiving the best grade of "A" were
Alaska, Connecticut, Massachusetts, Nevada, and Washington. States that
received an “F”, the worst grade, were Arkansas, Louisiana, Montana,
Oregon, and South Dakota.