June 13, 2014

Medicare to Cover Hepatitis C Screening

By cancerconnect

Medicare announced that it will cover screening for hepatitis C virus infection in high-risk individuals, including a one-time screening for all those born between 1946 and 1964.  High risk is defined for the purpose of the coverage decision as those who have "a current or past history of illicit injection drug use and/or a history of receiving a blood transfusion prior to 1992." To be covered, screening must be ordered by the person’s primary care provider.

The Centers for Medicare & Medicaid Services proposed the coverage based on the U.S. Preventive Services Task Force recommendations for screening which became available in March.   According to the decision memo annual rescreening will also be covered for high-risk Medicare beneficiaries who continue to use illicit injection drugs.

In recent years the treatment options for hepatitis C have significantly expanded.   Last year, the FDA approved sofosbuvir (Sovaldi®), for treatment of hepatitis C genotypes 1, 2, 3, or 4.  The FDA has also approved three protease inhibitors including boceprevir (Victrelis®), telaprevir (Incivek®), and simeprevir (Olysio®) for treatment of patients with the genotype 1 infection. Each of these treatments can be used in combination with pegylated interferon and ribavirin for the treatment of genotype 1 infection.


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