Effective January 20, 2023, PA requirements have been removed from the ADAP formulary for the following hepatitis C (HCV) medications: generic sofosbuvir-velpatasvir, generic ledipasvir/sofosbuvir and glecaprevir/pibrentasvir (Mavyret®).
Approximately 21 percent of people with HIV in the United States also have HCV infection, according to the Centers for Disease Control and Prevention. HCV is transmitted through direct contact with blood, which can occur if needles and other drug injection equipment are shared. Sexual transmission of HCV is uncommon but can occur if there is any blood present from a genital or anal lesion or wound. Chronic HCV infection causes liver inflammation that can eventually lead to cirrhosis, liver failure, and liver cancer, if untreated. In addition, people with HIV/HCV coinfection have higher levels of liver inflammation and a more rapid onset of these complications.
HCV infection is curable with an 8 to 12-week course of direct-acting HCV antivirals, but many people with HIV/HCV coinfection have not been able to access HCV treatment, including people enrolled in ADAP. By removing the PA requirement for three widely used HCV treatment regimens, CDPH hopes that providers can engage with and offer HCV treatment to ADAP patients with untreated HCV infection.
ADAP management requests that you share this information with your clinical leadership team and local prescribers. If you have any questions regarding this update, please contact the OA Formulary Specialist, James Vo, (James.Vo@cdph.ca.gov ).
Sharisse Kemp, MSW
ADAP Branch Chief
California Department of Public Health