Objective:

To evaluate hepatitis C care cascade outcomes among insured adults in the U.S. using various data sources.

Approach:

• Study Design: Cohort study utilizing the HealthVerity database, including laboratory results, pharmacy claims, and insurance enrollment information.
• Eligibility Criteria: Included U.S. adults aged ≥18 years with positive HCV tests between January 30, 2019, and June 30, 2021, and continuous insurance enrollment.
• Outcome Measures: Calculated care outcomes: viral clearance, treatment initiation, and viral clearance after treatment initiation.

Key Findings:

• Of4,515,568adultstestedforHCV,91,491everhadHCV(meanage,XXyears;46.8%female,53.2%male).62%hadinitialHCVinfection;39.9%achievedviralclearance,35.7%initiatedtreatment,and26.1%hadviralclearanceaftertreatmentinitiation.38.3%ofindividualswithinitialinfectiondidnothavefollow-upRNAtestingtoassessviralclearance.

Interpretation:

Laboratory result-based care outcomes may be limited by follow-up testing; pharmacy data can serve as a proxy for treatment initiation.

Limitations:

• Treatments outside of insurance claims may not be captured.
• Continuous enrollment requirement may exclude individuals with unstable insurance.
• Possible misclassification of infection status or outcomes due to reliance on laboratory data.

Conclusion:

Improving follow-up RNA testing and integrating data sources can enhance accuracy in measuring hepatitis C care outcomes.