Quest Diagnostics will automatically test for hepatitis C in anyone whose antibody screening results show they've been exposed to the virus, the company announced on Thursday. As a result, it will no longer provide stand-alone positive antibody screening of the virus.
The change is aimed at reaching the 60% of individuals who take a test that says they've been exposed to hepatitis C but don't undergo further testing to show the infection is currently active in their bodies.
Effective immediately, Madison, N.J.-based Quest will use the same blood draw from any positive antibody screening to perform the secondary, confirmation test. The antibody test costs Medicare $19.42. The test to confirm infection costs Medicare $58.29.
Rick Pesano, Quest's vice president of development, science and innovation, said it's inconvenient for the patient and inefficient for health systems to have tests that require the patient to return, and that is why so many fail to undergo follow up testing.
Pesano called the policy change "medically responsible and appropriate."
The Centers for Disease Control and Prevention calls for all baby boomers, who represent about 80 million to 82 million patients, to be tested for hepatitis C, in part because infection rates peaked in the 1970s and '80s. Blood used for transfusions was also not universally screened until 1992.
Most infected patients are unaware of their condition because it can be asymptomatic for decades. Hepatitis C is the most common chronic bloodborne infection in the country, affecting 3.9 million Americans.
When reflex, or confirmatory, testing like Quest will conduct was implemented at five health centers in Philadelphia, the number of patients who received a follow-up test increased by over 12%, according to a CDC study from May.
Dr. J. Mario Molina, CEO of Molina Healthcare, a Long Beach, Calif.-based group that helps several states manage pharmacy benefits for Medicaid enrollees, said because hepatitis C usually presents as a low-grade infection, he does not predict the number of people treated for hepatitis will increase significantly.
The condition is one of the costliest to treat. In fact, the hepatitis C medications Sovaldi and Harvoni, priced at more than a $1,000 a pill each, have become poster children for the drug cost crisis.
Daniel Hartung, an associate professor at Oregon State University with a focus on prescription drugs, said that significant payers like CVS Health and the Veterans Affairs Department, who experience high costs for treating hepatitis C, have contracted significant price discounts for common treatments like Harovni, so their prices will not be affected even if Quest's change leads to more hepatitis C patients.
More pharmaceutical companies are providing hepatitis C treatments as public awareness has increased, and Hartung said that may affect prices.
“There are rumblings that there might be some price competition but it's unclear how that is going to shake out until it actually happens in six to seven months,” Hartung said.