Hepatitis C Virus Screening among Medicaid-Insured Individuals with Opioid Use Disorder across Substance Use Disorder Treatment Settings.

ABSTRACT

Objective: Although the rapid increase in opioid use disorders (OUD) and concurrent increase in Hepatitis C virus (HCV) in the United States is well-documented, little is known about HCV testing among high-risk populations. We examine patterns of HCV testing across OUD treatment settings for individuals with OUD in New York. Methods: Using 2014 New York Medicaid claims data, we identified OUD diagnosis, OUD treatment (methadone, buprenorphine, naltrexone, other treatment (inpatient or outpatient non-medication-based psychosocial treatment, such as psychotherapy) and no treatment) utilization and HCV-testing status among beneficiaries. We performed multivariable logistic regression to identify factors associated with HCV screening across OUD treatment settings. Results: 79,764 individuals with OUD diagnoses were identified in 2014. The prevalence of HCV screening was 32.4%, 16.2%, 20.6%, 16.8%, and 18.1% for those receiving methadone, buprenorphine, naltrexone, other treatment, and no treatment, respectively. In the adjusted logistic regression, those receiving any OUD treatment had greater odds of being screened, with the highest odds among methadone clients. Conclusions: Engagement in medication for OUD is associated with increased HCV testing. Findings indicate the importance of access to medication-based treatment for OUD and a need to further improve HCV screening rates.