OBJECTIVES

: Compare characteristics of patients with Hepatitis C (HCV) who did and did not receive HCV antiviral treatment (AVT) in a managed care setting.

METHODS

: We used electronic health record (EHR) data from Kaiser Permanente Colorado (KPCO) to identify adult patients who tested positively for HCV (HCV RNA+) during 2005-2015. We classified patients by the timing of their first RNA+ lab result into three eras of AVT availability: era 1 (2005-2010, older interferons and ribavirin); era 2 (2011-2013, interferons with oral agents (“triple therapies”)); and era 3 (2014-2015, oral agents). Baseline characteristics (<= 12 months prior RNA+) including insurance status and Quan comorbidity scores of patients who did and did not receive AVT were compared within each era. Time to first AVT dispensing was also compared between eras.

RESULTS

: Among 1.1 million adults enrolled in KPCO during 2005-2015, 1,784 patients were RNA+, continuously enrolled at KPCO >= 12 months prior to first RNA+ and had no prior dispensing of AVT (era 1 n=1040; era 2 n=438; era 3 n=306).

Patients receiving AVT were more likely to have commercial insurance than patients not receiving AVT in eras 1 (87% and 81%, p<0.01) and 2 (87% and 74%, p<0.01); and less likely to have Medicaid in era (5% v 23%, p<0.01). Within eras, patients receiving AVT had lower compared to patients not receiving AVT. Compared to patients in eras 1 and 2, patients receiving AVT in era 3 had fewer (p<0.01) mean (SD) days between first RNA+ and first AVT dispensing (224.1 (200.3) in era 3 v 1221.1 (1254.4) and 819.2 (576.6) in eras 1 and 2, respectively).

CONCLUSIONS

: Compared to patients with no AVT, patients receiving AVT have fewer comorbidities. Patients received AVT sooner in era 3, which may be related to improved treatment tolerability and insurance status.