E0481 - High SVR Rates, Regardless of Race or Socioeconomic Class, in Patients Treated With HCV DAAs in Community Practice Using a Specialized Pharmacy Team
Texas Liver Institute/UT Health San Antonio/Health Outcomes Centers San Antonio, TX
Saatchi Kuwelker, MD1, Tamneet Basra, MD2, Harry Nguyen, DO2, Jae Kim, MD3, Robert Mitchell, MD3, Ruben Ramirez, MD4, Richard Guerrero, MD5, Bryan Hanysak, MD6, Carmen Landaverde, MD7, Fabian Rodas, MD8, Eugenia Tsai, MD8, Eric Lawitz, MD8, Kimberley Christensen, RPh, MBA9, Clarissa Vaughn, PharmD9, Kim Hinojosa, RN, MSN, FNP-C9, Nina Olvera, MPAS, PA-C9, Edna Caraballo-Gonzalez, PA-C9, Emma Pham, MPAS, PA-C9, Lisa Pedicone, PhD10, Fred Poordad, MD11 1UT Health San Antonio, San Antonio, TX; 2UT Health San Antonio/Texas Liver Institute, San Antonio, TX; 3Corpus Christi Gastroenterology, Corpus Christi, TX; 4Providence Gastroenterology and Liver Associates, El Paso, TX; 5Sun City Gastroenterology and Hepatology, El Paso, TX; 6Waco Gastroenterology Associates, Waco, TX; 7Texas Liver Institute, Austin, TX; 8Texas Liver Institute, San Antonio, TX; 9Health Outcomes Centers, San Antonio, TX; 10R&R Strategies, Inc., Bedminster, NJ; 11Texas Liver Institute/UT Health San Antonio/Health Outcomes Centers, San Antonio, TX
Introduction: Approved HCV DAA regimens can cure nearly all patients; however, socioeconomic disparities may impact access and outcome. This study assesses socioeconomic factors, differences in insurance coverage and the drug prior auth process in HCV-infected patients managed in community practices partnered with a dedicated pharmacy team with expertise in liver disease.
Methods: This IRB-approved, ongoing study captures data on a cohort of 2480 patients from community practices. Patients had chronic hepatitis C and were treated with DAA regimens selected by their physician. Median income is based on home zip code. The HCV Health Outcomes Centers (HOC) Network provides comprehensive patient management including a dedicated pharmacy support team with expertise in the prior auth process.
Results: In this cohort, 60.1% were male, 49% were Hispanic Whites (HW), 37% were Non-Hispanic Whites (NHW), and 14% were Black. Eighty-seven percent of patients were treatment naïve, 74% were infected with genotype 1 virus and 63% had advanced fibrosis/cirrhosis (F3/F4=68.2% HW, 65.6% Blacks, 55.4% NHW).
Table 1 depicts the distribution of socioeconomic characteristics by racial group. Forty percent of patients were on disability with the highest % in the Black group and less than 1/3 were employed full time, regardless of race/ethnicity. Medicare covered 42% of Black patients vs 32% of HW and NHW. The vast majority of HW (80%) and Blacks (75%) had a median income below the median income of Texas residents. Additionally, 75% of HW and 71% of Blacks had median income below the poverty level in Texas.
Despite the above socioeconomic factors, 92% of all prior authorizations were approved upon first submission and patients received DAAs an average of 17 days from prescription. DAA therapy resulted in cure in 95.3% of patients (SVR=94.8% HW, 94.0% Blacks, 96.5% NHW).
Discussion: Despite having more advanced disease and more negative socioeconomic factors, > 94% of HW and Blacks patients were cured. Continued patient education and communication with the healthcare team can lead to high adherence and > 94% HCV cure rates regardless of race/ethnicity or underlying socioeconomic factors in the community setting.
Figure: Table 1. Distribution of socioeconomic characteristics by racial group.
Disclosures:
Saatchi Kuwelker indicated no relevant financial relationships.
Tamneet Basra indicated no relevant financial relationships.
Harry Nguyen indicated no relevant financial relationships.
Jae Kim indicated no relevant financial relationships.
Robert Mitchell indicated no relevant financial relationships.
Ruben Ramirez indicated no relevant financial relationships.
Richard Guerrero indicated no relevant financial relationships.
Bryan Hanysak indicated no relevant financial relationships.
Carmen Landaverde indicated no relevant financial relationships.
Fabian Rodas indicated no relevant financial relationships.
Eugenia Tsai indicated no relevant financial relationships.
Kimberley Christensen indicated no relevant financial relationships.
Clarissa Vaughn indicated no relevant financial relationships.
Kim Hinojosa indicated no relevant financial relationships.
Nina Olvera indicated no relevant financial relationships.
Edna Caraballo-Gonzalez indicated no relevant financial relationships.
Emma Pham indicated no relevant financial relationships.
Lisa Pedicone indicated no relevant financial relationships.
Fred Poordad indicated no relevant financial relationships.
Saatchi Kuwelker, MD1, Tamneet Basra, MD2, Harry Nguyen, DO2, Jae Kim, MD3, Robert Mitchell, MD3, Ruben Ramirez, MD4, Richard Guerrero, MD5, Bryan Hanysak, MD6, Carmen Landaverde, MD7, Fabian Rodas, MD8, Eugenia Tsai, MD8, Eric Lawitz, MD8, Kimberley Christensen, RPh, MBA9, Clarissa Vaughn, PharmD9, Kim Hinojosa, RN, MSN, FNP-C9, Nina Olvera, MPAS, PA-C9, Edna Caraballo-Gonzalez, PA-C9, Emma Pham, MPAS, PA-C9, Lisa Pedicone, PhD10, Fred Poordad, MD11. E0481 - High SVR Rates, Regardless of Race or Socioeconomic Class, in Patients Treated With HCV DAAs in Community Practice Using a Specialized Pharmacy Team, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.