Pharmacists improve hepatitis C treatment access in San Francisco

New research highlights the importance of working with pharmacists to improve hepatitis C virus (HCV) treatment among high-risk groups. The study, known as the No One Waits (NOW) trial, focused on facilitating immediate treatment for patients diagnosed with HCV in community settings. The NOW trial demonstrated how a specialized pharmacy team helped patients start treatment on the same day they were diagnosed. Many people at risk for HCV, such as those who inject drugs or are homeless, face significant barriers to accessing treatment in the United States. This collaboration aimed to overcome these obstacles. Globally, around 50 million people live with chronic HCV, with about 1 million new infections each year. Direct-acting antiviral (DAA) medications can cure more than 95% of HCV infections, but many marginalized individuals still struggle to access them. Conducted in San Francisco from July 2020 to October 2021, the NOW trial included individuals who were homeless or injecting drugs and eligible for simplified HCV treatment. The study took place in community buildings and areas frequented by at-risk populations. Participants who tested positive for HCV were enrolled in the study and received a starter pack of treatment. They were then transitioned to insurance-covered medication once their eligibility was confirmed. The pharmacy staff worked closely with study clinicians to streamline medication access. From 492 participants tested, 111 were positive for HCV. Of these, 89 returned for results, and 87 began treatment immediately. The majority were male and had low incomes. Most participants successfully transitioned to insurance-covered medication within two weeks. The research shows that pharmacists play a crucial role in tackling the complex barriers to HCV treatment. With their support, patients can better navigate insurance and access necessary medications. This model of collaborative care could be applied in similar community programs to improve treatment access for HCV.