An essential reminder for you and payers on what is 'interferon ineligible'

CHICAGO — Kris V. Kowdley, MD, FACP, FACG, FGAF, has a message for physicians at Digestive Disease Week 2014: Make a list of what is interferon ineligible, and keep it handy.

“We are finding that payers are requiring documentation on interferon-ineligibility,” Kowdley, who is director of the Liver Center of Excellence in the Digestive Disease Institute at Virginia Mason Medical Center; clinical professor of medicine at the University of Washington in Seattle and clinical investigator at Benaroya Research Institute, told an audience on the final day of the conference. “We often have to be clear as to how we define interferon-ineligible.”

Kowdley said ineligible criteria, according to the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA), are:

Intolerance
Autoimmune hepatitis or other autoimmune disorders
Hypersensitivity to interferon or any of its components
Decompensated liver disease
Major, uncontrolled depressive illness
Cytopenia with a neutrophil count below 1,500, a platelet count below 90,000 or baseline hemoglobin below 10 g/dL
Preexisting history of cardiac disease

Kowdley said patients may ask about treatment with simeprevir (Olysio, Janssen) and sofosbuvir (Sovaldi, Gilead), so it is important to be able to justify alternative treatments to payers.

“I would encourage all of you to keep this on a little piece of paper, or a card because in our experience, as in many others, we are finding that payers are requiring documentation on interferon eligibility before we might use this regimen.”

Disclosure: Kowdley reports several financial relationships.