HHSC contracted with drug manufacturer AbbVie to improve awareness, screening, diagnosis, and treatment of Hepatitis C Virus (HCV) for Medicaid clients. HCV is a liver infection caused by a virus and often develops into a long-term or chronic illness. If untreated, HCV can cause significant damage to the body, such as liver cancer and cirrhosis.

HHSC considers HCV a significant burden to the health of individuals and revised the policies around the drugs used to treat HCV to make them easier to prescribe and obtain. AbbVie manufactures Mavyret (glecaprevir/pibrentasvir), HHSC’s preferred direct-acting antiviral (DAA), for treating HCV and is available without a prior authorization. The following are important notes about Mavyret:

• Used to treat adults and children 3 years of age and older with chronic HCV;
• Available to all Medicaid clients for DAA treatment, regardless of the client’s METAVIR fibrosis score;
• Available without a prior authorization or drug screening requirements;
• Can be prescribed by any Medicaid provider for an 8-week treatment duration, though providers may write refills for a more extended period if needed. Clients no longer need to request additional refills throughout their treatment duration.

HHSC requires prior authorization for non-preferred Hepatitis C agents, though the quantity limit increase applies to all agents in this class. Refer to the Pharmacy Provider Procedure Manual for information.

Testing

HHSC encourages Medicaid providers to evaluate their clients at risk for Hepatitis C or previously ineligible for HCV treatment to assess if they would benefit from treatment with Mavyret. The US Centers for Disease Control and Prevention (CDC) recommends all adults 18 and older test for HCV infection at least once in their lives, except in settings where the prevalence of HCV infection (HCV Ribonucleic Acid-positivity is less than 0.1%). They also recommend that people with certain risk factors, including people who inject drugs, be tested regularly.

• Refer to the CDC’s Testing Recommendations for Hepatitis C Virus Infection and the Questions and Answers For Health Professionals for more testing information.
• Refer to the AbbVie Provider Locator to find a HCV treatment provider in your area.