Barriers and Key Issues
HCV Treatment: Estimating the CostProviders planning to offer care and treatment to coinfected patients must adequately plan to meet client needs. Part of this planning means estimating the cost of care and establishing mechanisms for paying for it. HIV service providers are operating in a world with growing health care costs and growing HIV prevalence among the poor and uninsured. Many HIV/HCV-coinfected patients are also poor and underserved, and most rely on public support to meet care and treatment needs. Thus, providers must ask, Will we be overwhelmed by the high costs of providing HCV care and treatment to coinfected patients? By any standard, HIV diagnostics and treatment are expensive, as are the interventions for management of side effects, and providers must plan accordingly. Most Medicaid programs include medications for HCV treatment in their formularies, and 17 State AIDS Drug Assistance Programs (ADAPs) cover pegylated interferon and ribavirin (see Access to HCV Treatment and ADAPs).
But as discussed in the preceding pages, most people living with HCV do not receive treatment. It is hoped that improvements in access to high-quality, culturally competent care services will increase the number of people who do receive HCV treatment. But given the low utilization today of treatment—which is, by far, the most expensive element of care for coinfected patients—the cost of providing comprehensive HCV services will be less than prevalence data might suggest. * All costs described in this section are based on prices listed at drugstore.com
(accessed May 22, 2005).
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