Mo1411 - An Integrated Analysis of the Efficacy of Glecaparevir/Pibrentasvir by Geographical Region

Purpose: To evaluate rates of insurance approval for hepatitis C therapy with Velpatasvir/ Sofosbuvir at a single urban center and compare it to approval rates for Ledipasvir/Sofosbuvir in an urban single center population.Methods: Pharmaceutical records were reviewed for all patients prescribed Velpatasvir/Sofosbuvir (Therapy 1) and Ledipasvir/Sofosbuvir (Therapy 2) between January 2016 -July 2017.Data was extracted by retrospective chart review including type of insurance, insurance approval, initiation of therapy, alternate-support path offered and fibrosis staging based on fibro scan or liver biopsy.Descriptive analysis was then done to evaluate the approval rates for both the therapies.Results: The overall approval rate was similar between the two time periods, 74.6% for Therapy 1 versus and 79% for Therapy 2. When stratified by insurance type, the approval rates were again very similar as seen in table 1.Among patients that were denied of Therapy 1, 47% were approved for free drug therapy with ombitasvir/paritaprevir/ritonavir with dasabuvir whereas only a mere 17.6% denied of Therapy 2 were approved of alternate therapy.Advanced stages of were associated with better approval rates for both overall and for Medicaid patient in particular as can be seen in table 2. Conclusion: The economic disparity associated with poor insurance approval rate for Medicaid patients as compared to Medicare patients is mutual for both Velpatasvir/Sofosbuvir and Ledipasvir/Sofosbuvir.The approval rates are better for advanced stages of fibrosis for both the therapies.Given nearly only 50% of those denied by insurance are offered support path.The treatment option of those denied of these therapies are limited.Approval rates by insurance type comparing Therapy 1 vs Therapy 2 Approval rate by fibrosis stage comparing Treatment 1 vs Treatment 2 for patients overall and across Medicaid patients. Mo1410