Table 1.

Perceived Barriers to HCV Treatment

Patient-related
Fear of side-effects Medication expense Laboratory expense Low success rate of treatment Fear of stigma related to HCV Preference for alternative therapy Desire to wait for newer therapies Difficulty with administration Treatment duration Patient declines liver biopsy Inaccessibility of experienced providers
Government-related
Government restricts treatment Insufficient funds allocated to HCV Lack of promotion for HCV treatment
Provider-related
Treatment limited to government-mandated centers Lack of office infrastructure to treat patients Insufficient reimbursement for physicians Unable to obtain necessary labs for treatment Limited access to medications or labs Insufficient training for HCV management Lack of referral to HCV providers by other physicians Lack of proper storage for medications
Payer-related
Insurance plan does not cover treatment High out-of-pocket expense for patients Restricted insurance coverage for patients with HCV Insurance plans will not cover RNA/genotyping Excessive paperwork requirements Insurance plans limit which physicians treat HCV Insurer does not cover serum markers of fibrosis Insurance plans do not cover medications for side-effects Liver biopsy required for treatment

All barriers scored on a 10-point Likert scale, with 0 representing “not a barrier to treatment,” 5 representing “somewhat of a barrier to treatment,” and 10 representing “large barrier to treatment”