Important Notice: As of October 1, 2017, the MedStar Family Choice contract to provide Medicaid services to residents in the District of Columbia has ended. Learn more >
Important considerations when prescribing hepatitis C medications:
- Most patients must have a liver biopsy or other accepted test (e.g., FibroSure) demonstrating a Metavir score >1 (Fibrosure F1-2 range is acceptable). Patients with HIV or HBV co-infection do not require a minimum level of fibrosis (i.e. they may be treated regardless of Metavir score).
- A baseline viral load must be obtained within 90 days of the anticipated start of treatment.
- Mandatory virologic testing at 4, 12 and 24 weeks must be performed with the intent to discontinue treatment if there is inadequate viral response (defined in the MedStar Family Choice Hepatitis C Protocol).
- Initial medication approvals will be for 8 weeks of treatment. Additional medication will be approved only after lab testing is submitted at week 4 (and week 12 for patients in whom regimens extend greater than 12 weeks).
If you wish to prescribe hepatitis C treatment, please complete the Hepatitis C Prior Authorization Form (see link below) and fax it to 202-243-5496. This form will also serve as a prescription that will be forwarded to CVS Caremark Specialty Pharmacy allowing your patient to receive his/her medication. For any questions, please contact Danielle Gerry, MD at 410-933-2295 or Patryce Toye, MD at 410-933-2204.
Click here for the MedStar Family Choice Hepatitis C Protocol.
Click here for the Hepatitis C Prior Authorization Form.