Hepatitis C Linkage to Care Initiative

In 2019, the American Association for the Study of Liver Diseases (AASLD) – Infectious Diseases Society of America (ISDA) updated their guideline recommendations advocating for a multidisciplinary team of providers involved in the treatment of Hepatitis C virus (HCV) to increase access to care.¹ This reframing of the HCV care continuum has compelled innovative practice models for clinical pharmacists. The current wait time for HCV treatment can take 6-12 weeks or longer from the time of provider referral to a gastroenterology appointment for HCV treatment consideration, resulting in delayed labs and therapy starts. Health system specialty pharmacies (HSSP) can bridge this gap by prescribing HCV treatment through collaborative practice agreements (CPAs).

This single-center, retrospective study evaluated the impact of an HSSP CPA on time to the start of treatment for HCV access to care. Pharmacists reviewed patient charts from January to December 2021 to compare the average time from referral to treatment start date for patients that did receive pharmacist-prescribed treatment from the HSSP to patients who did not.

Results: Forty-five patients were identified as receiving HCV treatment services at the specialty pharmacy for assessment. All patients had labs ordered and screened prior to therapy start. A total of 12 patients that received a referral to the HSSP-managed CPA program were assessed and received prescribing, monitoring, and dispensing services for Hepatitis C medication by our HSSP pharmacists. In comparison, 33 patients only received monitoring and dispensing services at the HSSP. The referral to start date decreased by 33% for HCV treatment for HSSP CPA patients versus non-CPA prescribed patients.

Conclusions: HSSP CPA patients receiving HCV treatment had a referral to start date more than 35 days faster than non-CPA prescribed patients. HSSP CPAs play a pivotal role in decreasing the treatment start times for HCV access to care, closing a current gap in the care of HCV patients who’d otherwise have to wait longer for treatment.