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Overcoming the hurdles to Hepatitis C care in California

By Bill Remak, B. Sc. MT, B. PH., SGNA, AHCJ; Chairman, California Hepatitis C Task Force

The California Hepatitis C Task Force was started in 2002 and we help build public and private health partnerships to eradicate hepatitis C (HCV). Our work is focused on California with additional involvement in Viral Hepatitis activities nationally and globally.

As one of the early members of CPAT, we enjoy the opportunity to work in partnership with communities’ efforts that pool resources while using innovations in technology to address those unmet needs. This strategy has been very helpful in establishing best practices and is a process that requires ongoing development. We collaborate with providers and the research community to face the many challenges related to access, public awareness, education, quality of care and advocating for a reduction in healthcare disparities and improving patient centered care and medical home models for better patient outcomes.

Hepatitis C is a communicable blood-born liver disease that affects thousands of Californians. The Centers for Disease Control and Prevention’s estimate that over 650,000 Californians carry the HCV infection seems daunting--but over 60 percent are unaware of their infection. This issue continues to be a major motivator for health policy leaders to reduce the suffering, potential for liver cancer and liver transplants--a surgical intervention that is becoming very difficult due to the shortage of donors.

Patient advocates have adapted with innovations in research, technology and delivery to transform patient engagement and empowerment in this age of the Affordable Care Act. In particular, new treatments like Sovaldi could make Hepatitis C a rare disease by 2026. Innovative treatments like this are the type of medical breakthroughs that can drastically change the lives of Hepatitis C patients. Additionally, these new drugs are only expected to increase health care costs by half of one percent in 2014, and could prevent up to $85 billion in medical costs in the U.S. health care system.

The advantage of newer Hepatitis C medications and those in the pipeline are easily tolerated, cure patients and easier for case managers to administer. This is giving the workforce and patients some relief due to the shorter time of treatment and over 90 percent efficacy. Coordinated care models of delivery are bringing advance practice pharmacists and a more active participation of other health care workers into the team based care continuum.

Usually a person with chronic hepatitis C has several other chronic conditions that also need to be addressed to have an acceptable quality of life and lasting wellness. We are also acutely aware of the impact this has on the entire family and the extended community.

Our biggest challenges moving forward are:

1) Public awareness

2) Testing of all baby-boomers (people born between 1945 and 1965) and other risk factors.  See link here:  http://www.cdc.gov/hepatitis/hcv/guidelinesc.htm  

3) Timely and affordable access to care including liver cancer. 

4) Building capacity for education and delivery of providers.

5) Reduction in the organ donation crisis and its impact on liver disease.

6) Advocating for HCV vaccination research and development.

If you have any questions or are interested in setting up a program in your area, please don’t hesitate to drop me an email at wmremak@californiahcvtaskforce.org



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