HBV and HCV: America’s
Hidden Epidemics
Jeffrey Levi, PhD
Trust for America’s Health
October 14, 2010
Who We Are
 Trust for America’s Health (TFAH) is a
non-profit, non-partisan organization
dedicated to saving lives by pro...
Goals of the Report
 Follow-on to IOM report
 Concrete strategies for federal action
 Unique opportunities right now th...
Overview of Problem
 There are a number of unique challenges that must
be addressed when combating the hepatitis B virus
...
Key Findings
 Nearly two percent of the U.S. population may have
some form of the disease – and approximately five
millio...
Impacts on Diverse Populations
 Of the more than five million Americans with HBV
or HCV:
 Baby Boomers account for two-t...
Once-in-a-Generation Opportunity
 New prevention options and
treatment possibilities due to
Patient Protection and
Afford...
Key Recommendations
 Tracking hepatitis to better target
prevention and treatment efforts:
 Build on existing HIV survei...
Key Recommendations
 HBV and HCV screening and HBV
vaccinations should be the standard of care
in the reformed health car...
Key Recommendations
 Improve treatment by ensuring everyone who is
diagnosed is linked to care and receives the
standard ...
Key Recommendations
 Assure adherence to treatment:
 Treatment requires a continuum from point of
screening throughout c...
Key Recommendations
 Prevent New Infections:
 Eliminate newborn HBV infections
 CMS-CDC joint initiative
 Eliminate he...
Key Recommendations
 Strengthen research agenda:
 Single dose HBV vaccine; develop HCV vaccine;
simplify treatment optio...
The cost of doing nothing
 150,000 Americans could die from liver
cancer or end-state liver disease (IOM)
 Medical costs...
Questions?
 Please contact:
 Dara Lieberman, Government Relations Manager
dlieberman@tfah.org, 202-223-9870 x. 20
 Visi...
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Apha slides tfah hep b &c levi slides[1]

  1. 1. HBV and HCV: America’s Hidden Epidemics Jeffrey Levi, PhD Trust for America’s Health October 14, 2010
  2. 2. Who We Are  Trust for America’s Health (TFAH) is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.
  3. 3. Goals of the Report  Follow-on to IOM report  Concrete strategies for federal action  Unique opportunities right now through Affordable Care Act and scientific breakthroughs
  4. 4. Overview of Problem  There are a number of unique challenges that must be addressed when combating the hepatitis B virus (HBV) or hepatitis C virus (HCV), including:  health complications that take decades to develop;  significant social stigmas connected to the viruses;  disproportionately impacts racial, ethnic and sexual minorities; and  infectious disease prevention strategies have traditionally been siloed.
  5. 5. Key Findings  Nearly two percent of the U.S. population may have some form of the disease – and approximately five million of these individuals will develop a chronic form of the diseases.  An estimated 65 to 75 percent of the five million Americans currently infected with HBV or HCV do not even know they have the virus.
  6. 6. Impacts on Diverse Populations  Of the more than five million Americans with HBV or HCV:  Baby Boomers account for two-thirds of HCV cases - and if left untreated, it could lead to a major increase in upcoming Medicare spending;  African Americans account for 22 percent of HCV cases;  Asian and Pacific Islander Americans account for 50 percent of HBV cases; and  Gay and bisexual men account for 15 percent to 25 percent of new HBV cases and are at increased risk for HCV infection.
  7. 7. Once-in-a-Generation Opportunity  New prevention options and treatment possibilities due to Patient Protection and Affordable Care Act (ACA).  Scientific breakthroughs will make treatment, vaccination easier.
  8. 8. Key Recommendations  Tracking hepatitis to better target prevention and treatment efforts:  Build on existing HIV surveillance systems; strengthen state and local networks  Focus on tracking both cumulative cases and emerging outbreaks  Assure that emerging electronic health record system collects appropriate hepatitis-related data  Better tracking of new outbreaks
  9. 9. Key Recommendations  HBV and HCV screening and HBV vaccinations should be the standard of care in the reformed health care system:  Screen based on risk factors and age  Make this part of initial Medicare visit and essential health benefit under health reform  Reach out to non-traditional settings  HBV vaccination should be encouraged as part of the preventive benefit under health reform and monitored through electronic health records
  10. 10. Key Recommendations  Improve treatment by ensuring everyone who is diagnosed is linked to care and receives the standard of care:  Appropriate coverage and reimbursement for treatment  Public-private treatment guidelines updated regularly  Plans under Exchanges as well as Medicare and Medicaid required to meet treatment guidelines and have networks with qualified providers of hepatitis care  Improve referral systems  Expand access to wraparound services, perhaps through Ryan White Program
  11. 11. Key Recommendations  Assure adherence to treatment:  Treatment requires a continuum from point of screening throughout care  Provide appropriate culturally and linguistically sensitive support services  Special consideration for marginalized populations
  12. 12. Key Recommendations  Prevent New Infections:  Eliminate newborn HBV infections  CMS-CDC joint initiative  Eliminate health care-associated HBV and HCV infections  Promote universal HBV vaccination  Bolster prevention campaigns and public awareness
  13. 13. Key Recommendations  Strengthen research agenda:  Single dose HBV vaccine; develop HCV vaccine; simplify treatment options; rapid tests  Funding proportionate to public health risk  NIH funding for hepatitis research is ~$150 million
  14. 14. The cost of doing nothing  150,000 Americans could die from liver cancer or end-state liver disease (IOM)  Medical costs for HCV patients could double over the next 20 years from $30 billion to $80 billion (Milliman)  Many of these costs will be borne by Medicare and Medicaid  A comprehensive approach that includes early diagnosis and treatment can reverse this trend
  15. 15. Questions?  Please contact:  Dara Lieberman, Government Relations Manager dlieberman@tfah.org, 202-223-9870 x. 20  Visit TFAH online at www.healthyamericans.org
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