Measuring Medicaid Access to Care and its Downstream Implications: The Case of Hepatitis C




Associate Professor

Project Summary

My summer research experience gave me the hands-on skills necessary to begin engaging in independent research. Because this was one of my first research experiences, there were many aspects of research I knew nothing about – data analysis, grant writing, data requests, etc. My PI worked closely with me to make sure the knowledge I acquired this summer would be beneficial to my future research and career goals by teaching me how to use STATA, Tableau, and compose data requests for database entities. The research project I worked primarily on this summer was “Measuring Medicaid Access to Care and its Downstream Implications: The Care of Hepatitis C,” and essentially:


Hepatitis C is a viral infection that primarily attacks the liver and it is the deadliest infectious disease in the U.S. Hepatitis C infection can lead to liver cancer or cirrhosis, making it one of the top causes for liver transplants. Treatments for Hepatitis C were not very effective and had significant side effects up until 2013. This led to few people being treated and many going without a cure up until 2013, when the infection outlook fundamentally changed as a result of FDA approval for sofosbuvir.


Because it is highly effective and well tolerated, sofosbuvir is largely seen as a complete cure for the disease. However, the costs of these drugs are extremely high. Despite several substitutes, the per treatment cost still remains between $50,000-$100,000. With such high treatment cost, it may be that insurance coverage is the key to promoting access to care for Hepatitis C.


Early access to treatment for Hepatitis C is both best for the patient and cost-effective. However, the extreme expense of Hepatitis C treatment has led to unprecedented circumstances of rationing access to treatment drugs within the Medicaid market. Our research aimed to:

  1. Identify both interstate and intrastate variations in treatment access. Specifically, this study examined three domains: disease severity, prescribing limitations, and sobriety requirements.


  2. Examine how changes in access might impact treatment and prescribing behavior within the Medicaid program.

     3.  Examine the downstream effects of expanding access within the Medicaid program by examining liver transplants, Medicare prescribing behavior, and Medicare expenses for Hepatitis C.