Real-World Utilization of the HCV Care Cascade Before and After Implementation of a Program to Streamline Care and Promote Treatment

Objectives: The World Health Organization (WHO) goal of eradicating hepatitis C virus (HCV) infection by 2030 has encouraged healthcare providers to implement proactive strategies to improve diagnosis and treatment. The aims of this retrospective cohort study were to assess a program designed to improve the HCV care cascade and facilitate access to treatment, within a national healthcare provider in Israel, Maccabi Healthcare Services (MHS). Methods: Included were adult patients newly diagnosed with HCV infection before and after the implementation of a screening and care optimization program. Patients diagnosed in 2017 served as the reference group (RG), while those diagnosed in 2019 (following the program implementation) comprised the intervention group (IG). Study outcomes included completion of HCV laboratory testing, time to consultation with gastroenterologist/hepatologist (GE), and initiation of treatment with direct-acting antivirals (DAAs). Results: The study sample included 356 HCV Ab+ patients in the RG (median age = 46 years; 41% females), and 328 in the IG (median age = 48 years; 39% females). Compared to RG, IG demonstrated higher rates of patient visiting GE visit (78.1% vs. 63%) and initiating DAA treatment (66.3% vs. 35.5%). Conclusions: Implementation of a restructured HCV care cascade was associated with a greater proportion of patients receiving expert consultation and higher DAA treatment uptake, important steps towards HCV eradication.