In the United States, hepatitis A, hepatitis B and hepatitis C are the most common types, but also included are hepatitis D and E. CDC/ E.H. Cook, Jr.

Hepatitis C: Few Insured Persons Receive Timely Treatment, and Disparities Exist Interview with:
William W. Thompson, Ph.D.

Epidemiologist Division of Viral Hepatitis
CDC What is the background for this study?

Response: Prior to this analysis, we knew only an estimated 1.2 million persons initiated hepatitis C treatment with DAA agents in the United States during 2014–2020, far below the number needed to achieve national hepatitis C elimination goals. Further, the number of persons treated was highest in 2015 and declined to its lowest level in 2020.

This analysis used a large national health care claims database to assess the level and timing of hepatitis C treatment among persons with diagnosed HCV infection with breakdowns by sex, age, race, insurance type (i.e., private, Medicaid, and Medicare), and by state. What are the main findings?

Response:  We found that among adults aged 18–69 years with diagnosed HCV infection and continuous insurance coverage, approximately one third of those with private insurance and one quarter of Medicaid and Medicare recipients initiated Direct-acting antiviral (DAA) agents treatment within 12 months of diagnosis.

Medicaid and Medicare recipients with hepatitis C were 46% and 38% less likely, respectively, to receive timely treatment compared with those with private insurance.

And Medicaid recipients with diagnosed hepatitis C in states with Medicaid treatment restrictions were 23% less likely to receive timely treatment than were those living in states without restrictions. What should readers take away from your report?

Response: Few insured persons with diagnosed hepatitis C receive timely DAA treatment, and disparities in treatment exist. Unrestricted access to timely DAA treatment is critical to reducing viral hepatitis–related mortality, disparities, and transmission. Treatment saves lives, prevents transmission, and is cost saving. What recommendations do you have for future research as a results of this study?

Response: Additional research is needed to understand treatment levels among uninsured and undiagnosed people with hepatitis C, as well as analyses that can shed more light on treatment levels by more racial/ethnic groups. In addition to this, studies that further explore individual and structural barriers to hepatitis C treatment to better understand what are the greatest challenges to treatment faced by people with hepatitis C. Is there anything else you would like to add?

Response: These findings emphasize the need for:

  1. Interventions to increase access to hepatitis C treatment with DAA agents include removing policies limiting patient eligibility based on fibrosis stage or sobriety, requiring treatment through specialists, and requirement for preauthorization.
  2. Universal hepatitis C screening coupled with simplified treatment protocols should be integrated into primary care and other settings serving persons with hepatitis C, and the number of primary care providers treating hepatitis C expanded, especially Medicaid providers serving populations disproportionately affected by hepatitis C.
  3. Increasing access to hepatitis C treatment to all populations, regardless of insurance type, is essential to reducing viral hepatitis–related disparities and achieving hepatitis C elimination.


Thompson WW, Symum H, Sandul A, et al. Vital Signs: Hepatitis C Treatment Among Insured Adults — United States, 2019–2020. MMWR Morb Mortal Wkly Rep 2022;71:1011-1017. DOI:

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Last Updated on October 5, 2022 by Marie Benz MD FAAD