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. 2022 Jul-Aug;137(4):702-710.
doi: 10.1177/00333549211015664. Epub 2021 May 27.

Outcomes of a Pharmacist-Led Hepatitis C Virus Treatment Program in an Urban Safety-Net Health System, Chicago, 2017-2019

Bijou R Hunt  1 , Hollyn Cetrone  2 , Sharon Sam  1 , Nancy R Glick  1   3
Affiliations

Outcomes of a Pharmacist-Led Hepatitis C Virus Treatment Program in an Urban Safety-Net Health System, Chicago, 2017-2019

Bijou R Hunt et al. Public Health Rep. 2022 Jul-Aug.

Abstract

Objective: A recommendation in March 2020 to expand hepatitis C virus (HCV) screening to all adults in the United States will likely increase the need for HCV treatment programs and guidance on how to provide this service for diverse populations. We evaluated a pharmacist-led HCV treatment program within a routine screening program in an urban safety-net health system in Chicago, Illinois.

Methods: We collected data on all patient treatment applications submitted from January 1, 2017, through June 30, 2019, and assessed outcomes of and patient retention in the treatment cascade.

Results: During the study period, 203 HCV treatment applications were submitted for 187 patients (>1 application could be submitted per patient): 49% (n = 91) were aged 55-64, 62% (n = 116) were male, 67% (n = 125) were Black, and 15% (n = 28) were Hispanic. Of the 203 HCV treatment applications, 87% (n = 176) of patients were approved for treatment, 91% (n = 161) of whom completed treatment. Of the 161 patients who completed treatment, 81% (n = 131) attended their sustained virologic response (SVR) follow-up visit, 98% (n = 129) of whom reached SVR. The largest drop in the treatment cascade was the 19% decline from receipt of treatment to SVR follow-up visit.

Conclusion: The pharmacist-led model for HCV treatment was effective in navigating patients through the treatment cascade and achieving SVR. Widespread implementation of pharmacist-led HCV treatment models may help to hasten progress toward 2030 HCV elimination goals.

Keywords: hepatitis C; pharmacist-led; safety-net setting; treatment navigation; urban setting.

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Conflict of interest statement

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Hepatitis C virus treatment application approvals, by Metavir/fibrosis score and year, in an urban safety-net health system in Chicago, Illinois, January 1, 2017–June 30, 2019. A score of F0-F1 indicates absent or mild fibrosis, F2 indicates significant fibrosis, F3 indicates severe fibrosis, and F4 indicates severe liver disease or cirrhosis.
Figure 2
Figure 2
Hepatitis C virus treatment application denials, by health insurance type and year, in an urban safety-net health system in Chicago, Illinois, 2017-2019. Abbreviation: PAP, patient assistance program.
Figure 3
Figure 3
Initial hepatitis C virus treatment application outcomes, by health insurance type and year, in an urban safety-net health system in Chicago, Illinois, 2017-2019. Abbreviation: PAP, patient assistance program.
Figure 4
Figure 4
HCV treatment cascade among patients (n = 187) at an urban safety-net health system in Chicago, Illinois, 2017-2019. Abbreviation: HCV, hepatitis C virus.
See this image and copyright information in PMC

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