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New AASLD HCVGuidelines Restriction Language Posted Oct 24
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This is just unacceptable. State medicaid hearings use this language to justify restricting access to only F3/F4, there is no medical evidence to support this position, it is purely political & economic. The HCVGuidelines panel is a group of doctors who provide care & treatment to HCV-infected patients but they would not enforce the medicaid restriction on their own patients, if a patient with F1 tells any of them I want to be treated, they would, they understand HCC , liver cancer can start to develop during early stages & is undetectable at that point & once F3 develops the risk for HCC significantly increases, in fact if one has cirrhosis & is cured for the rest of their lives they must have an MRI every si months to see if HCC develops because the risk persists if one waits this long to be treated, all expert treaters in this field know this. There is no medical evidence to support delaying therapy, in fact all the evidence supports treating before F3 to prevent just what I described so why would the AASLD/EASL HCVGuidelines support such a patient-risky choice?
This is NO different than each of their prior 2 positions, they keep getting criticized, each time they say they will change guideline, but it is never a real change, you can see its obvious they want their cake & eat it to - they want to make it sound like they have adjusted their position but they STILL support prioritizing treatment for F3, as if its not obvious to everyone what the dynamics are here.
http://www.hcvguidelines.org/full-report/when-and-whom-initiate-hcv-therapy
WHEN AND IN WHOM TO INITIATE HCV THERAPY
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Successful hepatitis C treatment results in sustained virologic response (SVR), which is tantamount to virologic cure, and as such, is expected to benefit nearly all chronically infected persons. Evidence clearly supports treatment in all HCV-infected persons, except those with limited life expectancy (less than 12 months) due to non-liver-related comorbid conditions (See Unique Patient Populations). Urgent initiation of treatment is recommended for some patients, such as those with advanced fibrosis or compensated cirrhosis (see Table 1).
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