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HIV/HCV
Co-Infection
Watch

CANN's quarterly research product tracking state ADAP and Medicaid formularies for HIV/HCV co-infection coverage.

 

The Watch is the most comprehensive ongoing public record of how state programs cover the medications people with HIV and hepatitis C co-infection actually need. We publish four issues a year, each one updating the state-by-state formulary data, surfacing the trends and outliers, and analyzing what's changing in the policy and access landscape.

 

Use the Watch to:

Check formulary coverage in a specific state, compare states on a specific medication or class, track changes over time, or cite the most current public data in your own work.

The Latest Edition

How we build the Watch

We compile formulary, prior authorization, and step therapy data quarterly from publicly available state ADAP and Medicaid formulary documents. Every issue's methodology section names the sources, the cutoff date for the data, and any known gaps.

 

Read the full methodology →

Subscribe to the Co-Infection Watch Quarterly Updates

Past Editions

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Our Methodology

About the HIV/HCV Co-Infection Watch

 

The HIV/HCV Co-Infection Watch is a CANN research project that monitors and reports on HIV and Hepatitis C (HCV) co-infection in the United States. The Watch tracks coverage, access, and policy through a patient-centered lens — analyzing what people living with HIV and HCV actually encounter when they seek care.

 

Why this work matters

 

HCV-related liver failure is the leading non-AIDS-related cause of death among people living with HIV in the United States. Treating HCV is essential to HIV care, not optional.

 

Most people living with HCV — well over half — fall near, at, or below the Federal Poverty Level. Coverage for them typically runs through ADAP, Medicaid, Medicare, or the Veterans Affairs system. The Watch focuses on those patients, and on the people who still fall outside all of them.

 

What the Watch tracks

 

We collect and analyze, by state and territory:

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  • ADAP formulary coverage of HCV drug therapies

  • State Medicaid formulary coverage of HCV drug therapies

  • Veterans Affairs coverage of HCV drug therapies

  • Patient assistance programs (PAPs)

  • Harm reduction policy and data for HIV, HCV, and HIV/HCV co-infection

  • National and regional trends, and other relevant statistics

  • COVID-19's continuing impact on HIV- and HCV-related public health programs

 

How we classify coverage

 

For state and territory programs, coverage falls into three tiers:

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  • No coverage — no HCV treatments covered

  • Basic coverage — older regimens only (Ribavirin, Pegylated-Interferon, etc.); no Direct-Acting Antivirals

  • Expanded coverage — Direct-Acting Antivirals covered

 

Within Expanded coverage, we track specific products: Sovaldi, Harvoni, Zepatier, Epclusa, Vosevi, Mavyret, Pegasys, and the generic versions of Harvoni and Epclusa. The list grows as new therapies enter the market.

 

Methodology

 

Research is conducted from the patient's vantage point. The Watch researcher works the same paths a patient would: state- and privately-run program websites (public information only), publicly available reporting from non-profit and for-profit organizations, contact lists from public sources, and responses to a quarterly formulary survey sent to programs directly.

 

For every source we evaluate, we ask:

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  • Is the information readily available?

  • Is it clearly laid out and easy to understand?

  • Does it answer basic questions about coverage options?

  • Is it current and accurate?

  • Is the website usable?

  • Is contact information present and correct?

 

Findings are documented and presented in plain language, with maps and tables that show what coverage looks like across the country. States or territories where information could not be located — whether unpublished by the program or unanswered after outreach — appear greyed out on maps and are left blank or marked with "?" in spreadsheets.

 

Disclaimer

 

Opinions expressed in Watch reports are CANN's. They do not represent the official positions of any program directors, employees, funders, or service providers connected to ADAP, Medicaid, or any other program referenced.

 

The Watch's purpose is to give a clearer picture of the HCV treatment landscape for people co-infected with HIV and HCV. Color coding signals coverage gaps; it does not imply judgment of program staff or providers.

 

Any observations or recommendations about the design, content, or maintenance of state-run websites reflect the Watch researcher's view and are not a verdict on the programs or the people who run them.

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