title: The time and cost investment required to obtain and initiate direct-acting antiviral therapy.
abstract: Obtaining direct-acting antiviral (DAA) medications for treatment of HCV is labour-intensive for providers. The purpose of this study was to assess the amount of unbillable time and to estimate the financial burden of obtaining DAAs for HCV.
  
  
  
  Patients prescribed DAA therapy from 30 September 2014 to 19 March 2015 at an academic hepatology practice were enrolled prospectively. Providers recorded the amount of time required to obtain HCV therapy for each patient.
  
  
  
  A total of 79 patients consented, 27 of whom were excluded due to incomplete data or deferment of therapy. In our patient population 56% of patients had private insurance, 27% Medicare and 15% Medicaid. The median time spent per patient was 92.5 min (IQR 80.00-108.80). The median cost spent per patient was $78.85 (IQR 66.75-94.30).
  
  
  
  Development of a streamlined process to reduce the time and cost for physicians to obtain DAAs is needed. Removing this barrier will encourage physicians to adopt HCV treatment to address the large number of patients in need.
authors.affiliation: Department of Hepatology, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Veronica
authors.initials: V
authors.lastname: Loy
authors.affiliation: Department of Hepatology, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Tamara
authors.initials: T
authors.lastname: Benyashvili
authors.affiliation: Department of Hepatology, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: William
authors.initials: W
authors.lastname: Adams
authors.affiliation: Department of Hepatology, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Pavkov
authors.affiliation: Department of Hepatology, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Meghan
authors.initials: M
authors.lastname: O'Mahoney
authors.affiliation: Department of Hepatology, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Cotler
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D017048:Health Care Costs; D006297:Health Services Accessibility; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D000998:Antiviral Agents