HIV/HCV Co-Infecon Watch: 21 Annual Monitoring Report The HIV/HCV Co-Infecon Watch is a publicaon of the Community Access Naonal Network (CANN). It is a paent-centric informaonal portal serving three primary groups Paents, Healthcare Providers, and AIDS Service Organizaons. Learn more: h"p://www.(icann.org Community Access Naonal Network (CANN) Naonal Monitoring Report on HIV/HCV Co-Infecon Page 1
Background Launched in January 2 Monthly summary on relevant data on co-infecon of human immunodeficiency virus (HIV) and hepas C (HCV) Inially, limited focus on: AIDS Drug Assistance Programs Medicaid Latest News related to HIV/HCV and Co-Infecon Subsequently, expanded focus on: Veterans Harm Reducon Regional Trends Community Access Naonal Network (CANN) Naonal Monitoring Report on HIV/HCV Co-Infecon Page 2
Background What s included Overview Findings AIDS Drug Assistance Programs (ADAPs) Medicaid Programs Veterans Programs Harm Reducon Programs Regional Trends Latest News Contact Informaon Disclaimer Methodology References Community Access Naonal Network (CANN) Naonal Monitoring Report on HIV/HCV Co-Infecon Page 3
ADAP HCV DAA Trends: 2-21 Coverage Trends January 2: States offering Expanded Coverage (CA, CO, HI, IA, MA, MN, NJ) States offering only Basic Coverage 24 June 2: States offering Expanded Coverage 11 (AZ, AR, CA, CO, HI, IA, LA, MA, MN, NJ, SD) States offering only Basic Coverage 24 January 2: States offering Expanded Coverage 1 (AZ, AR, CA, CO, DE, HI, IA, ME, MA, MN, NJ, OK, PA, TN, VA, WA, DC) States offering only Basic Coverage 1 June 2: States offering Expanded Coverage 2 (AZ, AR, CA, CO, DE, FL, GA, HI, IL, IA, LA, ME, MD, MA, MN, NE, NH, NJ, OK, PA, SD, TN, VA, WA, DC, PR) States offering only Basic Coverage - January 21: States offering Expanded Coverage 29 (AZ, AR, CA, CO, DE, FL, GA, HI, IL, IA, LA, ME, MD, MA, MN, NE, NH, NJ, NY, OK, OR, PA, SD, TN, VA, WA, WI, DC, PR) States offering only Basic Coverage August 21: States offering expanded coverage 33 (AZ, AR, CA, CO, DE, FL, GA, HI, IL, IA, LA, ME, MD, MA, MN, MO, MT, NE, NH, NJ, NY, ND, OK, OR, PA, SD, TN, TX, VA, WA, WI, DC, PR) States offering only Basic Coverage - 12 States have connued to expand coverage as newer, cheaper HCV DAAs hit the market. Expansion has slowed significantly over the past year Harvoni, Zepaer, and Viekira Pak are the most covered drugs 29, 2, & 2, respecvely Olysio and Viekira XR are the least covered drugs 19 & 1, respecvely Mavyret s WAC of $39, for 12 weeks, $2,4 for weeks Community Access Naonal Network (CANN) Naonal Monitoring Report on HIV/HCV Co-Infecon Page 4
ADAP Expanded Coverage: January 2 - June 2 Community Access Naonal Network (CANN) Naonal Monitoring Report on HIV/HCV Co-Infecon Page 5
ADAP Expanded Coverage: January 2 June 2 Community Access Naonal Network (CANN) Naonal Monitoring Report on HIV/HCV Co-Infecon Page
ADAP Expanded Coverage: January - August 21 Community Access Naonal Network (CANN) Naonal Monitoring Report on HIV/HCV Co-Infecon Page
ADAP HCV Drug Ulizaon: January 2 August 21 ADAP HCV Drug Adop(on: January 2 - August 21 35 3 2 1 5 1 3 2 1 9 12 11 12 11 12 12 Sovaldi Olysio 14 12 1 5 Harovoni 14 1 4 14 23 22 23 22 2 2 24 23 24 23 21 21 1 11 11 9 9 14 14 Viekira Pak 23 22 23 22 23 22 23 22 23 2 1 14 1 14 Daklinza 14 1 9 14 12 11 5 4 4 1 2 2 2 2 2 2 24 24 21 2 2 2 2 2 21 21 21 19 1 19 1 19 1 1 29 2 29 2 29 2 2 2 2 21 22 21 22 21 19 19 1 19 1 11 5 Technivie Zepaer Epclusa Viekira XR Community Access Naonal Network (CANN) Naonal Monitoring Report on HIV/HCV Co-Infecon Page
HCV Rates Compared to ADAP Coverage Ten Highest Rates of HCV Infection (2) 1 2 3 4 5 Massachusetts West Virginia Kentucky Tennessee Maine Indiana New Mexico Montana New Jersey Alabama 9 North Carolina Ohio 1 Wisconsin 3. 3.4 2. 2. 2.3 2.1 1.9 1.5 1.5 1.4 1.4 1.1 1.1 Community Access Naonal Network (CANN) Naonal Monitoring Report on HIV/HCV Co-Infecon Page 9
2-21 Trends: Medicaid Coverage Trends January 2: States offering Expanded Coverage 3 States offering only Basic Coverage 12 (AK, AR, CA, CT, FL, KS, MI, NM, ND, RI, SC, TX) June 2: States offering Expanded Coverage 39 States offering only Basic Coverage 11 (AR, CA, CT, FL, KS, MI, NM, ND, SC, TX, WA) January 2: States offering Expanded Coverage States offering only Basic Coverage 2 (AR, MI) June 2: States offering Expanded Coverage 5 States offering only Basic Coverage 1 (AR) August 2 August 21: States offering Expanded Coverage 51 States offering only Basic Coverage All states currently offer Expanded Coverage for HCV drugs Medicaid programs quicker to adopt HCV drugs than ADAPs States with mulple coverage plans are likelier to have plans offering only one or two HCV DAAs Community Access Naonal Network (CANN) Naonal Monitoring Report on HIV/HCV Co-Infecon Page 1
Medicaid Expanded Coverage: January 2 June 2 Community Access Naonal Network (CANN) Naonal Monitoring Report on HIV/HCV Co-Infecon Page 11
Medicaid Expanded Coverage: January 2 June 2 Community Access Naonal Network (CANN) Naonal Monitoring Report on HIV/HCV Co-Infecon Page 12
Medicaid Expanded Coverage: August 2 August 21 Community Access Naonal Network (CANN) Naonal Monitoring Report on HIV/HCV Co-Infecon Page
Medicaid HCV Drug Ulizaon Medicaid HCV Drug Adop(on: January 2 - August 21 5 4 39 3 39 3 39 3 4 39 4 39 4 39 4 39 3 3 39 3 3 3 3 4 39 32 3 2 29 2 29 2 29 2 29 2 41 3 3 3 2 24 5 41 31 41 35 41 41 3 3 22 1 41 3 29 2 1 41 1 19 1 4 Sovaldi Olysio Harovoni Viekira Pak Daklinza Technivie Zepaer Epclusa Viekira XR Community Access Naonal Network (CANN) Naonal Monitoring Report on HIV/HCV Co-Infecon Page 14
21 Trends: Veterans Affairs Coverage Trends: The Report began covering VA HCV coverage in March 2 Coincided with VA announcement of universal coverage for all eligible VA members Most-used drugs: Epclusa (); Harvoni (1); Zepaer (1) VA connues to provide most effecve treatment program in government-funded healthcare Community Access Naonal Network (CANN) Naonal Monitoring Report on HIV/HCV Co-Infecon Page
21 Trends: Harm Reducon Harm Reducon measures becoming more popular: CDC Public Health Law Program site for Prescripon Drugs not updated since August 2: Syringe Services Programs (SSPs) Expanded Naloxone Access Data difficult to track Reports outdated Primary barriers to Harm Reducon Measures: Syringe Exchange: Data vs. Percepon Enabling Condoning Safety/Biohazardous Waste Mandatory PDMP Use: Physician/Pain Advocate opposion Outdated soqware/interface / User unfriendly Time hassle Community Access Naonal Network (CANN) Naonal Monitoring Report on HIV/HCV Co-Infecon Page
21 Trends: Harm Reducon Primary barriers to Harm Reducon Measures: Doctor Shopping: Federal blanket statute Reporng/Checking hassle Physical Exam Requirement: Physician/Pain Advocate opposion Too me consuming Too onerous Paent mobility/barriers to accessing care/treatment ID Requirement for Purchase of Prescripon Opioid Drugs: Pain Advocate opposion Burden on poor/minority paents Hardware update costs for scanning Government tracking Prescriber Educaon: Physician opposion Time consuming Pharmacy Lock-In Programs: Outdated/User unfriendly soqware/interface Paid Advocate opposion Barrier to accessing care/treatment Community Access Naonal Network (CANN) Naonal Monitoring Report on HIV/HCV Co-Infecon Page 1
Harm Reducon Measures: August 2 vs. 21 Community Access Naonal Network (CANN) Naonal Monitoring Report on HIV/HCV Co-Infecon Page 1
Contact Informaon Community Access Naonal Network (CANN) 124 Florida Avenue, NW Washington, DC 29 (22) 29-219 www.icann.org hrp://www.icann.org/co-infecon-watch.html Bill Arnold, President & CEO weaids@icann.org Marcus J. Hopkins, Project Director mhopkins@icann.org Community Access Naonal Network (CANN) Naonal Monitoring Report on HIV/HCV Co-Infecon Page 19