title: Considerations on bringing warehoused HCV patients into active care following interferon-free, direct-acting antiviral drug approval.
abstract: OBJECTIVE
  Until recently, lack of efficacious and tolerable hepatitis C virus (HCV) treatments prompted patient warehousing until better treatment options became available. We investigated whether the introduction of ledipasvir/sofosbuvir precipitated patient return to clinics, thereby changing HCV clinic dynamics.
  
  
  METHODS
  Online questionnaire responses indicated the volume of HCV patients followed, the proportion of warehoused patients and those who were proactively offered new options, methods for identifying and contacting patients, and insurance authorization/reimbursement-related information.
  
  
  RESULTS
  Of 168 practices surveyed, 19% indicated no patient warehousing in the previous 3 years; 81% had warehoused 40% of patients; 92% were able to handle their patient load; and 82% had not changed practices to accommodate more HCV patients in the previous 12 months. Of the 35% of patients who were ledipasvir/sofosbuvir-eligible, 50% already completed/are completing therapy, 21% were not treated due to insurance denial, and 19% were awaiting responses from insurance companies.
  
  
  CONCLUSIONS
  Launch of a new treatment did not overburden HCV practices. Patients eligible to receive new treatments were being treated, but pre-authorization processes and reimbursement denials reduced the numbers of treated patients.
authors.affiliation: a Deerfield Institute , New York , NY , USA.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Palak
authors.affiliation: a Deerfield Institute , New York , NY , USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Livoti
authors.affiliation: a Deerfield Institute , New York , NY , USA.
authors.forename: Céline
authors.initials: C
authors.lastname: Audibert
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D005260:Female; D005449:Fluorenes / Q000627:therapeutic use*; D005838:Genotype; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D007345:Insurance Claim Review; D007356:Insurance, Pharmaceutical Services; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D000069474:Sofosbuvir; D011795:Surveys and Questionnaires; D014481:United States; D014542:Uridine Monophosphate / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D001562:Benzimidazoles; D005449:Fluorenes; C000595958:ledipasvir, sofosbuvir drug combination; D014542:Uridine Monophosphate; D000069474:Sofosbuvir
keywords: HCV; Harvoni; Interferon-free therapy; ledipasvir/sofosbuvir; warehousing