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. Author manuscript; available in PMC: 2014 Apr 1.
Published in final edited form as: Hepatology. 2013 Apr;57(4):1325–1332. doi: 10.1002/hep.26246

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”