Hep See Success
Two Members’ Hep C Treatment Success
In October 2021, Mr. D came to AbsoluteCare with a host of comorbidities: type 2 diabetes, coronary artery disease, hypertension, and hepatitis C. Several months earlier, he’d undergone a triple bypass and was suffering from complications at the graft site, which sent him to the ED many times.
Before he joined AbsoluteCare, Mr. D had been diagnosed with HCV and had begun the approval process for Epclusa, a successful treatment, in November 2020. Despite the fact that this member’s Metavir score—figures that determine the extent of liver fibrosis—showed severe disease progression, his insurance denied the claim.
Our member was frustrated. He’d had HCV for quite some time, and no one could help him get his much-needed medication.
Within a week and a half of joining, he’d been seen by our infectious disease specialist, Dr. Ebama, and had begun testing. He started medication therapy on January 22, and by the following month, his viral load went from 250,000 to undetected. And that’s where his load has remained, though the end of July.
Mr. D recently told his case manager: “I am doing very well, especially with all my tests getting better! I don’t want to go back to being sick again.” His pod team is bent on making sure that doesn’t happen.
Member E joined AbsoluteCare in April 2021, after a traumatic motor vehicle collision. She had a mass on her lung and psychiatric concerns. Contributing to her state of ill health were housing insecurity, a lack of transportation, and a psychiatric disability.
Because she had a history of substance use, Ms. E was tested for and diagnosed with HCV. A chart review showed that she’d had the disease for at least six months prior to coming to AbsoluteCare but was never told.
When she was first diagnosed with HCV, Ms. E was angry and confused. She had been in recovery from substance use disorder for a year and had a difficult time understanding that this was a consequence of her substance use.
Ms. E is currently on medication therapy, and her viral load will be retested in a few short weeks. She is looking forward to closing the substance abuse chapter in the book of her life, with HCV the final hurdle.