{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T03:30:55Z","timestamp":1792467055926,"version":"4.5.0"},"reference-count":12,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,2,3]],"date-time":"2016-02-03T00:00:00Z","timestamp":1454457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Despite the clinical success in the real\u2010world of all oral hepatitis C virus (<jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content>) therapy with response rates approaching that seen in the clinical trials, access has been limited by many payers with discussion of prioritization of treatment based upon <jats:styled-content style=\"fixed-case\">AASLD<\/jats:styled-content> guidelines. We evaluated patients in the <jats:styled-content style=\"fixed-case\">TRIO<\/jats:styled-content> network who were prescribed sofosbuvir (<jats:styled-content style=\"fixed-case\">SOF<\/jats:styled-content>)\u2010based regimens to determine reasons for not starting treatment. Trio Health is a disease management company that works in partnership with academic medical centres, community physicians and specialty pharmacies in the United States to optimize care for <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content>. Data for 3841 patients prescribed a sofosbuvir\u2010containing regimen between December 2013 and September 2014 were obtained through this programme. Of the entire group, 315 (8%) patients did not start the prescribed sofosbuvir\u2010containing therapy. A total of 141 (45%) of the nonstart patients had a commercial plan as their primary insurance, 137 (44%) were primarily covered by Medicaid, 17 (5%) were primarily covered by Medicare, and 20 (6%) were either without coverage or coverage was not specified. Reasons for nonstarts were varied and overlapping. Only 15 patients (5% of nonstarts) did not start because they were unreachable or failed to complete required testing. Another 39 patients who did not start (12%) were following their physicians' direction to either wait for new treatment options or to hold treatment for an unspecified reason. Insurance\u2010related processes and financial reasons accounted for 254 (81%) of the 315 nonstarts. The remaining 7 (2%) patients did not have a specified reason for not starting treatment. Nonstart rates were highest in the Medicaid\u2010covered population at 35%. Medicare and Commercial nonstart rates were 2% and 6%, respectively. In a matched comparison, patients with commercial coverage were 6.5 times as likely to start <jats:styled-content style=\"fixed-case\">SOF<\/jats:styled-content>\u2010based therapy compared to patients with Medicaid. Despite high <jats:styled-content style=\"fixed-case\">SVR<\/jats:styled-content> rates of <jats:styled-content style=\"fixed-case\">SOF<\/jats:styled-content>\u2010based regimens in clinical practice, there are still barriers to access to care. In fact, almost half of the nonstart patients had advanced fibrosis scores (F3 or F4) and should have been prioritized to start treatment. As better treatment for <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> with high efficacy and low side effect rates become available, the disparity in access to treatment, as evidenced by the high nonstart rate in the Medicaid\u2010covered group, must be resolved.<\/jats:p>","DOI":"10.1111\/jvh.12506","type":"journal-article","created":{"date-parts":[[2016,2,3]],"date-time":"2016-02-03T16:07:36Z","timestamp":1454515656000},"page":"447-454","source":"Crossref","is-referenced-by-count":56,"title":["Disparate access to treatment regimens in chronic hepatitis <scp>C<\/scp> patients: data from the <scp>TRIO<\/scp> network"],"prefix":"10.1111","volume":"23","author":[{"given":"Z. M.","family":"Younossi","sequence":"first","affiliation":[{"name":"Center for Liver Diseases Department of Medicine Inova Fairfax Hospital Falls Church VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. R.","family":"Bacon","sequence":"additional","affiliation":[{"name":"Division of GI and Hepatology Saint Louis University School of Medicine St. Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. T.","family":"Dieterich","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine Mount Sinai New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. L.","family":"Flamm","sequence":"additional","affiliation":[{"name":"Feinberg School of Medicine Northwestern University Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Kowdley","sequence":"additional","affiliation":[{"name":"Liver Care Network Swedish Medical Center Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Milligan","sequence":"additional","affiliation":[{"name":"Trio Health Analytics La Jolla CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Tsai","sequence":"additional","affiliation":[{"name":"Queens Medical Center University of Hawaii Honolulu HI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Nezam","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,2,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1402355"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61036-9"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14-1313"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27161"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2014.09.025"},{"key":"e_1_2_6_7_1","unstructured":"ApplebyJ.There's a Life\u2010Saving Hepatitis C Drug. But You May Not Be Able To Afford It. Available at:http:\/\/kaiserhealthnews.org\/news\/insurers-debate-who-should-get-costly-hepatitis-c-drug\/(accessed 3 March 2014)."},{"key":"e_1_2_6_8_1","unstructured":"Sadeghi\u2010NejadN.Sovaldi and the Cost\u2010Innovation Paradox. Forbes. Available at:http:\/\/www.forbes.com\/sites\/natesadeghi\/2014\/03\/27\/breaking-the-bank-the-innovation-cost-paradox-of-us-healthcare\/(accessed 27 March 2014)."},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/M15-0406"},{"key":"e_1_2_6_10_1","unstructured":"PollackA.AbbVie Deal Heralds Changed Landscape for Hepatitis Drugs. New York Times. Available at:http:\/\/www.nytimes.com\/2014\/12\/22\/business\/pharmacy-deal-heralds-changed-landscape-for-hepatitis-drugs.html?_r=0(accessed 22 December 2014)."},{"key":"e_1_2_6_11_1","first-page":"S\u2010220A","article-title":"Evaluation of sofosbuvir and simeprevir\u2010based regimens in the TRIO network: academic and community treatment of a real\u2010world, heterogeneous population","volume":"60","author":"Dieterich D","year":"2014","journal-title":"Hepatology"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2011.568786"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301231"}],"container-title":["Journal of Viral Hepatitis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjvh.12506","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjvh.12506","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jvh.12506","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T06:26:49Z","timestamp":1695536809000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jvh.12506"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,2,3]]},"references-count":12,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2016,6]]}},"alternative-id":["10.1111\/jvh.12506"],"URL":"https:\/\/doi.org\/10.1111\/jvh.12506","archive":["Portico"],"relation":{},"ISSN":["1352-0504","1365-2893"],"issn-type":[{"value":"1352-0504","type":"print"},{"value":"1365-2893","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2,3]]}}}