Hepatitis C Treatment for Patients Without Insurance in a Student-Run Free Clinic: Analysis of Demographics, Cost, and Outcomes

Abstract

Background: Hepatitis C virus (HCV) predominantly affects marginalized patients, who have been reported to lack access to effective treatment. A high overlap exists between those at risk for HCV and those cared for by student-run free clinics. The purpose of this study is to present how one student-run free clinic provides accessible HCV care to patients as a model for other free clinics to offer similar services.

Methods: Data was reviewed from the electronic medical record and MedData Services, a software for management of patient assistance program (PAP) applications. Data collected included information regarding HCV diagnosis, treatment, and medication access process.

Results: At our clinic, there were 23 patients with a documented diagnosis or prior history of HCV infection. Treatment was initiated in 83% (n = 19) of patients, and 89% (n = 17) of these patients completed treatment. Most patients (84%, n = 16) received HCV medications directly through Shade Tree Clinic. All but three patients were treated with Harvoni®. All patients with available laboratory data
(n = 13) at >12 weeks status-post treatment had achieved sustained viral response. PAP applications were successfully approved for 89% (n = 17) of submitted applications (n = 19), representing the primary avenue for our clinic to access HCV treatments.

Conclusions: Our experience with HCV demonstrates that effective HCV treatment is feasible in a student-run free clinic setting.