Hepatitis C Cure Rates High, But Treatment Access Lags – New Study Findings

March 25, 2026 Ananya Mittal - World Editor

A concerning trend is emerging in the treatment of hepatitis C: despite the availability of highly effective antiviral medications, prescriptions are declining, potentially leaving a significant number of curable patients untreated. A recent study, published in JAMA, reveals a sharp decrease in prescriptions for direct-acting antivirals (DAAs) between 2015 and 2025, raising questions about access to care and the potential for stalled progress in eliminating this chronic liver disease.

Understanding Hepatitis C and the Promise of DAAs

Hepatitis C is a viral infection that attacks the liver, and if left untreated, can lead to serious health problems, including cirrhosis, liver cancer, and liver failure. Direct-acting antivirals represent a major breakthrough in treatment. These medications can cure hepatitis C in over 95% of individuals treated, a remarkable success rate compared to older therapies. However, access to these life-changing drugs remains a significant barrier. Currently, only about one in three people diagnosed with hepatitis C in the United States receive treatment within a year of diagnosis.

The Rise and Fall of Prescriptions: A New Analysis

Researchers from Mass General Brigham and the University of Virginia School of Medicine analyzed a large national prescription database spanning from 2013 to 2025. Their findings, detailed in the JAMA study, display that DAA prescriptions surged after their initial availability, peaking in 2015. This initial increase was driven by treatment among older adults and those with Medicare or commercial insurance. However, the study reveals a subsequent and substantial decline in prescriptions through 2025. The analysis as well noted a shift in who is receiving treatment, with a growing proportion of younger patients and those covered by Medicaid accessing DAAs over time.

The decline in specialist prescribing is particularly noteworthy. Prescriptions from specialists, who often diagnose and manage complex cases of hepatitis C, peaked in 2015 and have steadily decreased since then. This suggests potential challenges in identifying and referring patients for treatment. You can identify more information about the study’s methodology and findings here.

Who is Most Affected by This Trend?

The decreasing prescription rates have implications for public health efforts to eliminate hepatitis C. While treatment initially focused on older populations with more comprehensive insurance coverage, the shift towards younger patients and Medicaid beneficiaries is a positive development. However, the overall decline in treatment levels raises concerns that progress towards elimination may be slowing or even reversing. The study’s authors suggest that this trend may explain why hepatitis C prevalence hasn’t fallen as expected in recent years, and may have even increased in some areas.

It’s important to note that hepatitis C disproportionately affects certain populations, including people who inject drugs, individuals who received blood transfusions before 1992 (when screening began), and those with certain medical conditions. Reduced access to treatment within these groups could exacerbate existing health disparities.

Beyond the Numbers: Understanding the Barriers to Treatment

The study highlights a critical issue: the availability of a cure doesn’t automatically translate into widespread treatment. Several factors likely contribute to the decline in DAA prescriptions. These include:

  • Lack of awareness: Many people with hepatitis C are unaware they are infected, as the infection often has no symptoms in its early stages.
  • Limited screening: Insufficient screening programs mean that many cases go undiagnosed.
  • Financial barriers: While DAAs are highly effective, they can be expensive, and insurance coverage may be limited.
  • Stigma: Stigma associated with hepatitis C, particularly among people who inject drugs, can discourage individuals from seeking testing and treatment.
  • Healthcare access: Limited access to healthcare, especially for underserved populations, can create barriers to diagnosis and treatment.

Mass General Brigham Health Plan notes that they will continue to review non-preferred Hepatitis C medications on a case-by-case basis and cover them when medically necessary, as outlined in their pharmacy policies.

What Does This Mean for Public Health Efforts?

Eliminating hepatitis C requires a multifaceted approach that goes beyond simply developing effective treatments. The study’s senior author, Benjamin Rome, MD, MPH, emphasizes that “elimination will require system-level changes, not just better screening.” This includes expanding access to screening, reducing financial barriers to treatment, addressing stigma, and improving coordination of care.

Public health surveillance plays a crucial role in monitoring the prevalence of hepatitis C and tracking the impact of treatment programs. The Centers for Disease Control and Prevention (CDC) provides data and resources on hepatitis C, including information on screening, testing, and treatment. You can find more information on the CDC’s Hepatitis C website.

Looking Ahead: Addressing the Challenges

The recent decline in hepatitis C antiviral prescriptions underscores the need for renewed efforts to address this public health challenge. Several key areas require attention:

  • Increased screening: Expanding screening programs, particularly among high-risk populations, is essential for identifying undiagnosed cases.
  • Improved access to treatment: Reducing financial barriers and streamlining the treatment process can help ensure that more people receive the care they need.
  • Addressing stigma: Public health campaigns can help reduce stigma and encourage individuals to seek testing and treatment.
  • Enhanced surveillance: Continued monitoring of hepatitis C prevalence and treatment rates is crucial for tracking progress and identifying areas where interventions are needed.

The Mass General Brigham study serves as a critical reminder that even with a cure available, achieving elimination requires sustained commitment and a comprehensive, system-level approach. Individuals concerned about potential exposure to hepatitis C should consult with a qualified healthcare professional for testing and guidance.