Physicians, case managers, and HCV patients recommend a simplified strategy for baseline testing and minimal monitoring for treatment of hepatitis C virus infection with DAA therapies.

OBJECTIVES

In Taiwan, comprehensive pretreatment assessments and laboratory monitoring visits are required for patients receiving National Health Insurance Administration-reimbursed direct-acting antiviral (DAA) treatment, with results reported via the virtual private network (VPN) registration system. The study aims to gather opinions on a simplified DAA treatment strategy, assess its feasibility, and understand the burden of HCV treatment adherence.

METHODS

A non-interventional prospective survey study was conducted from October 17 to December 20, 2022. A total of 100 HCV patients, 50 physicians, and 20 case managers participated via a hybrid survey. Patients were grouped into comorbidity, special populations, and others (3:1:1). Factors influencing adherence to a simplified DAA treatment strategy versus current NHIA requirements were analyzed.

RESULTS

Fifteen percent of patients declined treatment, and 15 % experienced interruptions. Key barriers included low perceived disease severity (47 %), concerns about treatment effectiveness (40 %) and logistical challenges. Physician and case managers cited poor physical performance (46 %, 55 %) and treatment intolerance (42 %, 50 %) as major medical reasons for discontinuation. The COVID-19 pandemic disrupted care for 16 % of physician-reported and 35 % of case manager reported cases. Additionally, 58 % of physicians and 40 % of case managers found the VPN system overly complex or unnecessary.

CONCLUSIONS

Educating patients on HCV treatment benefits is crucial for improving adherence. Individualized monitoring, streamlined VPN requirements and expanded telemedicine use may reduce treatment burden and enhance long-term success.