Racial-Ethnic Disparities in Uptake of New Hepatitis C Drugs in Medicare

Jeah (Kyoungrae) Jung, Roger Feldman

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Chronic hepatitis C is an important public health concern. Recently launched drugs to treat hepatitis C virus (HCV) infection are effective but costly. Uptake of innovative and expensive prescription drugs may not be even across patient groups. We examined racial-ethnic disparities in uptake of new HCV drugs in the first year of their use (year 2014) in Medicare. Methods: The study population was Medicare beneficiaries who had chronic hepatitis C in 2013 or 2014 and who were continuously enrolled in Part D stand-alone Prescription Drug Plans in 2014. We examined trends in monthly uptake of new HCV drugs and adjusted annual uptake rates by race. We used logistic regressions to obtain adjusted odds ratios and adjusted differences in annual uptake rates. Results: Monthly uptake of new HCV drugs was lower among Black Medicare patients than Whites or Hispanics in 2014. The racial gap in monthly uptake became narrower toward the end of the year. Adjusted odds of using new HCV drugs were 11% lower for Blacks with cirrhosis than Whites (odds ratio (OR) = 0.89; 95% confidence interval (CI), 0.84–0.95), and 16% lower for Blacks with HCV/HIV coinfection than Whites (OR = 0.81; 95% CI, 0.72–0.92). Annual uptake rates were not significantly different for Whites and Hispanics. Conclusions: Black Medicare patients with cirrhosis or HCV/HIV coinfection had lower uptake rates than Whites in 2014. As utilization of new HCV drugs increases, continuing efforts will be necessary to ensure equal delivery of the drugs.

Original languageEnglish (US)
Pages (from-to)1147-1158
Number of pages12
JournalJournal of Racial and Ethnic Health Disparities
Volume4
Issue number6
DOIs
StatePublished - Dec 1 2017

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Hepatitis C
Medicare
Hepacivirus
contagious disease
drug
Pharmaceutical Preparations
Prescription Drugs
Odds Ratio
Chronic Hepatitis C
Coinfection
Hispanic Americans
Fibrosis
HIV
Confidence Intervals
medication
confidence
Virus Diseases
Public Health
Logistic Models
public health

All Science Journal Classification (ASJC) codes

  • Health(social science)
  • Anthropology
  • Sociology and Political Science
  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

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title = "Racial-Ethnic Disparities in Uptake of New Hepatitis C Drugs in Medicare",
abstract = "Background: Chronic hepatitis C is an important public health concern. Recently launched drugs to treat hepatitis C virus (HCV) infection are effective but costly. Uptake of innovative and expensive prescription drugs may not be even across patient groups. We examined racial-ethnic disparities in uptake of new HCV drugs in the first year of their use (year 2014) in Medicare. Methods: The study population was Medicare beneficiaries who had chronic hepatitis C in 2013 or 2014 and who were continuously enrolled in Part D stand-alone Prescription Drug Plans in 2014. We examined trends in monthly uptake of new HCV drugs and adjusted annual uptake rates by race. We used logistic regressions to obtain adjusted odds ratios and adjusted differences in annual uptake rates. Results: Monthly uptake of new HCV drugs was lower among Black Medicare patients than Whites or Hispanics in 2014. The racial gap in monthly uptake became narrower toward the end of the year. Adjusted odds of using new HCV drugs were 11{\%} lower for Blacks with cirrhosis than Whites (odds ratio (OR) = 0.89; 95{\%} confidence interval (CI), 0.84–0.95), and 16{\%} lower for Blacks with HCV/HIV coinfection than Whites (OR = 0.81; 95{\%} CI, 0.72–0.92). Annual uptake rates were not significantly different for Whites and Hispanics. Conclusions: Black Medicare patients with cirrhosis or HCV/HIV coinfection had lower uptake rates than Whites in 2014. As utilization of new HCV drugs increases, continuing efforts will be necessary to ensure equal delivery of the drugs.",
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Racial-Ethnic Disparities in Uptake of New Hepatitis C Drugs in Medicare. / Jung, Jeah (Kyoungrae); Feldman, Roger.

In: Journal of Racial and Ethnic Health Disparities, Vol. 4, No. 6, 01.12.2017, p. 1147-1158.

Research output: Contribution to journalArticle

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AB - Background: Chronic hepatitis C is an important public health concern. Recently launched drugs to treat hepatitis C virus (HCV) infection are effective but costly. Uptake of innovative and expensive prescription drugs may not be even across patient groups. We examined racial-ethnic disparities in uptake of new HCV drugs in the first year of their use (year 2014) in Medicare. Methods: The study population was Medicare beneficiaries who had chronic hepatitis C in 2013 or 2014 and who were continuously enrolled in Part D stand-alone Prescription Drug Plans in 2014. We examined trends in monthly uptake of new HCV drugs and adjusted annual uptake rates by race. We used logistic regressions to obtain adjusted odds ratios and adjusted differences in annual uptake rates. Results: Monthly uptake of new HCV drugs was lower among Black Medicare patients than Whites or Hispanics in 2014. The racial gap in monthly uptake became narrower toward the end of the year. Adjusted odds of using new HCV drugs were 11% lower for Blacks with cirrhosis than Whites (odds ratio (OR) = 0.89; 95% confidence interval (CI), 0.84–0.95), and 16% lower for Blacks with HCV/HIV coinfection than Whites (OR = 0.81; 95% CI, 0.72–0.92). Annual uptake rates were not significantly different for Whites and Hispanics. Conclusions: Black Medicare patients with cirrhosis or HCV/HIV coinfection had lower uptake rates than Whites in 2014. As utilization of new HCV drugs increases, continuing efforts will be necessary to ensure equal delivery of the drugs.

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