Hepatitis C Treatment in Kentucky Medicaid Recipients with Concurrent Opioid Use Disorder: A Cross-Sectional Study.

BACKGROUND

Hepatitis C virus (HCV) infections and injection drug use have concurrently increased in the last decade. Evidence supports simultaneously treating chronic HCV and opioid use disorder (OUD) with medication. Kentucky is a hard-hit state for both conditions that has undertaken policy and practice efforts to increase access to both types of medications.

OBJECTIVE

To examine receipt of direct-acting antivirals (DAAs) for patients living with HCV-OUD and received any vs. no medications for opioid use disorder (MOUD).

DESIGN

We conducted a cross-sectional study using a proprietary dataset from HealthVerity of health claims between 1/1/2020 and 12/31/2021.

PATIENTS: Kentucky Medicaid beneficiaries aged ≥ 18 with concurrent chronic HCV-OUD diagnoses.

MAIN MEASURES: Multivariable logistic regression models were used to calculate adjusted proportions of HCV DAA receipt based on receipt of MOUD, adjusting for patient characteristics and region.

KEY

RESULTS

Of 2149 patients, 36% (n = 780) received HCV DAAs; 84% (n = 1804) received any MOUD during the study period. Buprenorphine was the most common MOUD type used (n = 1414, 66%). Adjusting for covariates, HCV DAA receipt was lower among people who received any vs. no MOUD (33% vs. 46%, p < 0.0001). Methadone (vs. no MOUD, 29% vs. 46%, p = 0.0002) had the greatest difference in odds of HCV DAA receipt.

CONCLUSIONS

Gaps in HCV treatment among Kentucky Medicaid recipients with OUD were pervasive. Despite evidence supporting HCV-OUD co-treatment, patients receiving MOUD were significantly less likely to receive curative HCV treatment.