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National Prescribing Trends of Direct-Acting Antivirals for Hepatitis C
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Download the PDF here
Download the PDF here
"What is most concerning is that estimates suggest the rate of people acquiring new hepatitis C infections is rising -- and that between 2.5 million and 4 million Americans still remain infected several years after these cures were available," Kishore https://www.medpagetoday.com/infectiousdisease/hepatitis/120513
Researchers found that prescriptions rose rapidly after DAAs first became available, peaking in 2015, but then declined sharply through 2025.
Since initially becoming available in 2013, direct-acting antivirals (DAAs) have transformed the treatment of hepatitis C virus (HCV) infection. Treatment is well tolerated and results in cure (sustained virologic response) in more than 95% of individuals. However, only about a third of people in the US with HCV infection receive treatment within a year of diagnosis, an estimated 2.5 million to 4 million remain chronically infected, and incident cases of HCV have increased during the last decade.1,2 To better understand how the use of DAAs has evolved in the US, this study measured changes in patient and prescriber characteristics for these medications from 2013 to 2025.
In more recent years, the annual treatment volume (approximately 69 000 courses) was similar to the estimated number of incident HCV infections in the US but is substantially below the approximately 260 000 annual treatment courses needed to achieve national elimination targets.5 This may explain why HCV prevalence in the US did not decrease in 2017 to 2020 compared with earlier periods, and may have even increased according to estimates of national surveys adjusting for underrepresentation of people who inject drugs.2
To increase HCV treatment and support eradication in the US, several changes are needed. Improved screening is important but insufficient; in 1 trial, less than 20% of those diagnosed by universal screening received treatment.6,7 Further efforts to accelerate progress include expanded point-of-care diagnostics to facilitate same-day treatment, implementing telehealth and mobile outreach, and financing reforms such as the proposed national subscription model under the Cure Hepatitis C Act of 2025.8-10
The age distribution of patients being prescribed DAAs shifted over time, with adults older than 61 years accounting for 41.8% of treated patients in 2015 compared with 26.0% in 2025, while individuals younger than 40 years increased from 5.4% in 2015 to 28.9% in 2025 (Figure 2C).
But rates of people >60 remain remains high.
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