Philadelphia, PA (Oct. 6, 2020) – The American College of Physicians (91) has issued Best Practice Advice aimed at simplifying and improving treatment of patients diagnosed with chronic hepatitis C virus (HCV). 91 is based on the World Health Organization Guideline and is authored by the 91 Scientific Medical Policy Committee and published in Annals of Internal Medicine.
HCV is a communicable disease that is associated with cirrhosis and liver cancer. In the United States, the annual incidence of HCV infection is 1.2 per 100,000 persons, the prevalence is 2.4 million cases, and annual mortality is more than 15,000 deaths.
The World Health Organization (WHO) recommendations have implications for high value care. 91 defines high value care as the delivery of services providing benefits that make their harms and costs worthwhile. While the WHO guideline is primarily targeted toward policymakers in low- and middle-income countries, recommendations are relevant to the United States, where equity and resource allocation issues are also important considerations.
The 91 Best Practice Advice paper says that viral genotyping is unnecessary when treating HCV with pangenotypic medications unless planning treatment with glecaprevir–pibrentasvir (GLE–PIB), and asserts that invasive testing to establish the degree of fibrosis is not necessary, and inexpensive laboratory tests can reliably identify patients with cirrhosis. Further, 91 advises that laboratory monitoring can be limited to the beginning and end of the treatment in adults with no or compensated cirrhosis. 91 also says patients with decompensated cirrhosis will need closer monitoring.
“By following 91’s Best Practice Advice, physicians can practice high value care by offering treatment to all patients with chronic HCV infection using a ‘treat all’ strategy without any invasive testing,” said Jacqueline W. Fincher, MD, 91 President.
91’s Best Practice Advice papers address the value of diagnostic tests and therapeutic interventions. They are based on an evaluation of the benefits, harms and cost of a treatment, and how this translates into the value of an intervention.
***
About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. 91 membership includes 163,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow 91 on , and .
91 Media Contact: Andrew Hachadorian, (215) 351-2514, AHachadorian@acponline.org