title: Racial-Ethnic Disparities in Uptake of New Hepatitis C Drugs in Medicare.
abstract: BACKGROUND
  Chronic hepatitis C is an important public health concern. Recently launched drugs to treat hepatitis C virus (HCV) infection are effective but costly. Uptake of innovative and expensive prescription drugs may not be even across patient groups. We examined racial-ethnic disparities in uptake of new HCV drugs in the first year of their use (year 2014) in Medicare.
  
  
  METHODS
  The study population was Medicare beneficiaries who had chronic hepatitis C in 2013 or 2014 and who were continuously enrolled in Part D stand-alone Prescription Drug Plans in 2014. We examined trends in monthly uptake of new HCV drugs and adjusted annual uptake rates by race. We used logistic regressions to obtain adjusted odds ratios and adjusted differences in annual uptake rates.
  
  
  RESULTS
  Monthly uptake of new HCV drugs was lower among Black Medicare patients than Whites or Hispanics in 2014. The racial gap in monthly uptake became narrower toward the end of the year. Adjusted odds of using new HCV drugs were 11% lower for Blacks with cirrhosis than Whites (odds ratio (OR) = 0.89; 95% confidence interval (CI), 0.84-0.95), and 16% lower for Blacks with HCV/HIV coinfection than Whites (OR = 0.81; 95% CI, 0.72-0.92). Annual uptake rates were not significantly different for Whites and Hispanics.
  
  
  CONCLUSIONS
  Black Medicare patients with cirrhosis or HCV/HIV coinfection had lower uptake rates than Whites in 2014. As utilization of new HCV drugs increases, continuing efforts will be necessary to ensure equal delivery of the drugs.
authors.affiliation: The Pennsylvania State University, University Park, PA, 16802, USA. kuj11@psu.edu.
authors.forename: Jeah
authors.identifier: http://orcid.org/0000-0001-7574-0677
authors.initials: J
authors.lastname: Jung
authors.affiliation: University of Minnesota, Minneapolis, MN, USA.
authors.forename: Roger
authors.initials: R
authors.lastname: Feldman
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D060085:Coinfection / Q000208:ethnology; D005260:Female; D005355:Fibrosis / Q000208:ethnology; D015658:HIV Infections / Q000208:ethnology; D054625:Healthcare Disparities / Q000208:ethnology*; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D054524:Medicare Part D; D008875:Middle Aged; D055553:Prescription Drugs / Q000191:economics / Q000627:therapeutic use*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
chemical_list: D055553:Prescription Drugs
keywords: Disparities; Hepatitis C; Medicare Part D; New hepatitis C drugs; Prescription drugs