While there are highly effective treatments for the hepatitis C virus (HCV), only 1 in 5 Medicaid enrollees diagnosed with HCV started treatment, according to a retrospective study led by researchers at Weill Cornell Medicine and Cornell University’s Ithaca campus. The findings revealed that treatment uptake rates were even lower among people under 30, women, Hispanic and Asian individuals, as well as people who inject drugs. The research underscores the urgent need for public health and policy efforts to improve initiation and reduce treatment disparities in Medicaid beneficiaries.

“Direct-acting antiviral treatments for hepatitis C infection introduced in the past decade achieved cure rates consistently higher than 90 percent in clinical trials and are well tolerated,” said lead study author Dr. Shashi Kapadia, an assistant professor of medicine in the Division of Infectious Diseases and of population health sciences at Weill Cornell Medicine. “However, we’re nowhere close to reducing the burden of hepatitis C in the United States and are falling well short of the WHO target to eliminate HCV by 2030.”

Hepatitis C is a viral infection that causes liver damage and inflammation. It spreads through contact with the blood of an infected person. In the United States, sharing injection drug equipment and having unprotected sex are the most common sources of HCV transmission. It was previously concentrated in the baby boomer generation, but in recent years, infection rates have increased in other groups, including those under 40 and people who inject drugs. Fifty-five percent of people who inject drugs are Medicaid beneficiaries.

For their study, published Aug. 4 in JAMA Network Open, the investigators examined medication uptake rates within six months of diagnosis for adults ages 18 to 64 using national Medicaid claims from 2017 to 2019. They analyzed disparities by age, sex, race and ethnicity, as well as injection drug use, alcohol use disorder, mental health diagnoses, cirrhosis and HIV infection.

The analysis revealed only 20 percent, about 18,000 of approximately 87,500 Medicaid enrollees diagnosed with HCV, began treatment within six months. Treatment uptake rates were significantly lower among particular groups: 17 percent for women compared with 23 percent for men, 14 percent for those ages 18 to 29 compared with 24 percent for those 50 to 64, and 18 percent for people with a history of injection drug use compared with 23 percent for those with no history of injection drug use. Treatment rates were also lower for Asian and Native Americans at 17 percent and 16 percent, respectively, compared with 20 percent for non-Hispanic white people. After adjusting for the influence of other clinical and sociodemographic factors, they also found lower treatment rates among Hispanic individuals compared to non-Hispanic white individuals.

“Our findings highlight the need for targeted outreach programs to ensure more younger people, and particularly those who inject drugs, are tested for hepatitis C and educate both patients and providers that treatment is highly effective and prevents a lot of suffering,” said Dr. Kapadia, who is also an attending physician at NewYork-Presbyterian/Weill Cornell Medical Center. “We also need more studies to determine the underlying drivers of lower treatment access in some of these groups, such as women and Asian and Native American populations, so that we can tailor interventions to raise their treatment rates.”

This study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK123205) and the National Institute on Drug Abuse (K01DA048172, P30DA040500) of the
National Institutes of Health.

Maccabiah Games medalist Dr. Matthew Simon is a table tennis whiz

What do infectious disease and internal medicine have to do with competitive table tennis? Not a lot. And that's one reason why Dr. Matthew Simon loves the game. "Ping-pong is so totally different from what I do as a doctor," says Dr. Simon, an assistant professor of medicine and of healthcare policy and research and a member of the Division of Infectious Diseases. "And it's simply a great stress reliever."

Dr. Simon is no casual player. He's a former Junior Olympian and top-ranked paddle master whose aggressive game and tricky forehand lend new meaning to the phrase "spin doctor." Last summer, Dr. Simon played for Team USA at the 19th annual Maccabiah Games in Israel, commonly known as the Jewish Olympics. Team USA won the bronze after toppling the U.K., ping-pong's country of origin.

It was a highlight of an athletic career that began in the family basement in Syracuse, N.Y., when Dr. Simon was 12. Eventually his father, an internist, introduced him to competitive ping-pong at places like the Polish American Citizens Club, a far cry from the family den. "Watching the games was just mesmerizing," Dr. Simon says. "There was this whole underworld of competitive table tennis that I discovered." From the local table tennis club in Syracuse, he went on to hone his skills at ping-pong camps and tournaments; by high school, he was nationally ranked in the top15 among players under 16. Dr. Simon continued to play competitively in college, helping start a team at the University of Pennsylvania. He took a seven-year hiatus from the sport during medical school and residency, but picked it up again when the Manhattan table tennis club Spin opened in 2009. By 2013, he was back in form and qualified for the Maccabiah Games, training and practicing several evenings a week.

What began as a leisurely British parlor game in the 19th century is now one of the fastest ball sports in the world — particularly given the close quarters in which it's played — with projectiles traveling up to 80 miles per hour across a nine-by-five-foot surface. "It's fantastic exercise, but it's not just about speed," Dr. Simon says. "A lot of the game is strategy. It's as much mental as physical." Dr. Simon likens it to a mix of boxing, running and chess. "You have to think fast and think ahead." Even if there is little direct connection to his profession, those are transferrable skills — and Dr. Simon has used them well. In spring 2013, he collaborated with New York City's Department of Health in responding to an outbreak of meningitis; last fall, he helped NewYork-Presbyterian Hospital deal with the Ebola threat.

Considering the demands of his day job, Dr. Simon has thought of retiring from the competitive ping-pong circuit. But he says he'll keep working on his game, in part because the sport has a rejuvenating quality. "When I'm playing, I meet a completely different circle of people, from all nationalities and walks of life," he says. "I love how the sport brings together people from such diverse backgrounds. So the game and my work do relate. Table tennis helps refresh my desire to find out what's unique about each of my patients."

— Franklin Crawford

This story first appeared in Weill Cornell Medicine,Vol. 14, No. 1.

NEW YORK (December 4, 2014) — Weill Cornell Medical College announced today that it has received a $25 million gift from Gale and Ira Drukier to establish a premier, cross-disciplinary institute dedicated to understanding the underlying causes of diseases that are devastating to children. Its goal will be to rapidly translate basic research breakthroughs into the most advanced therapies for patients.

The extraordinary gift names the Gale and Ira Drukier Institute for Children's Health and will enable the medical college to recruit a team of leading scientists, including a renowned expert who will serve as the Gale and Ira Drukier Director, to pursue innovative research that improves treatments and therapies for the littlest patients. The Drukier Institute, a marquee program that will be headquartered on the 12th floor of Weill Cornell's new Belfer Research Building, will also expand and enhance the medical college's already-distinguished research and clinical care programs that strive to end diseases and disorders that affect children and adolescents, including asthma, autism, cancer, cardiovascular disease, infectious diseases and schizophrenia."We couldn't be more grateful to Gale and Ira, whose generous gift exemplifies their commitment to advancing human health and their steadfast support of Weill Cornell Medical College," said Sanford I. Weill, chairman of the Weill Cornell Board of Overseers. "The Drukiers' investment will better the lives of children in New York and beyond, and will leave a lasting mark on our next generation."

"We are greatly appreciative of Gale and Ira Drukier, whose remarkable gift will enable Weill Cornell to expand its world-class research and clinical care programs for children, who can't be treated like little adults," said Dr. Laurie H. Glimcher, the Stephen and Suzanne Weiss Dean of Weill Cornell Medical College. "The Drukiers' generosity is critical in allowing us to attract the best and brightest minds in pediatric research, who will lead the way as we pursue innovative treatments and therapies that will ensure the health of children now and in the future."

"As parents and grandparents, Gale and I appreciate the tremendous impact medicine can have on growing children," said Dr. Ira Drukier, a member of the Weill Cornell Board of Overseers. "When you cure children, you give them their entire life back. It's with immense pride that we are able to make this investment, which will empower Weill Cornell Medical College to focus and direct all of its outstanding pediatric research under the auspices of one institute and provide vital resources to develop tomorrow's treatments and cures."

"It gives us great joy to be able to support Weill Cornell Medical College and make such a tremendous difference in children's lives," Dr. Gale Drukier said. "This gift also continues our enduring relationship with Cornell University, with which we have been connected for 40 years."

The Drukiers have a legacy of philanthropy at Cornell University, having provided generous support to its Herbert F. Johnson Art Museum and College of Architecture, Art and Planning.

"We at Cornell are immensely grateful to Gale and Ira Drukier for their extraordinary leadership and generosity, which has already been felt across the university," President David Skorton said. "With this spectacular new gift, the Drukiers are enabling us to achieve an unprecedented level of excellence in pediatric research. The bench-to-bedside approach of the Drukier Institute will have a lasting impact on children and their families, giving hope when they need it most."

"The gift from Gale and Ira Drukier establishing the Drukier Institute for Children's Health makes a powerful statement about the importance of focusing the energies of a major research institution on improving the health and wellbeing of children," said Dr. Gerald M. Loughlin, the Nancy C. Paduano Professor of Pediatrics and chairman of the Department of Pediatrics at Weill Cornell Medical College and pediatrician-in-chief at NewYork-Presbyterian/Weill Cornell Medical Center. "It is a wonderful legacy for these visionary philanthropists."

Caring for children is particularly challenging because their bodies are constantly changing as they grow, and their metabolisms and immune systems are vastly different than those of adults. Understanding the factors that spur growth in children can present possible lines of inquiry into other diseases, such as cancer, because tumors are also programmed to grow. There are also many genetic and developmental diseases that arise in childhood and pose serious health risks during adulthood. But treating these conditions can be arduous for pediatric patients. Many of the common treatments and therapies available to adults have toxic effects on children, making it critical to devise new and better interventions.

Using genomics and other cutting-edge research approaches, the cross-disciplinary Drukier Institute will drive excellence and innovation in pediatrics, seeking to rapidly and seamlessly catalyze research breakthroughs into the most advanced, safe and effective patient care. The Drukiers' generosity will empower the medical college to recruit five top-flight investigators — including a faculty member who conducts clinical research in pediatric genetics — to augment the distinguished team of physician-scientists already at Weill Cornell, as well as train the next generation of researchers in the field.

To help realize this vision, the Drukiers' gift will enable Weill Cornell to secure the latest research equipment, such as sequencing and informatics technology, as well as develop an infrastructure to establish a biobank. Investigators at the institute will work in close collaboration with clinicians in Weill Cornell's Department of Pediatrics to ensure that children immediately benefit from the latest research advances.

To encourage and support faculty development, research and education, the gift will endow the Drukier Lectureship, an annual lecture at Weill Cornell on a research or clinical topic in the field of children's health. It will also establish the Drukier Prize, which will be awarded once a year to a junior faculty member in the United States or abroad for excellence and achievement in advancing research on childhood diseases or disorders.

About Gale and Ira Drukier

A Cornell University graduate, Ira Drukier is co-owner of BD Hotels, LLC, a real estate development company that owns and operates more than two-dozen hotel properties in New York City, including the Mercer, Hotel Elysee and the Maritime.

Dr. Drukier graduated from Cornell in 1966 with a Bachelor of Science in Engineering with a focus on solid-state physics and in 1967 with a Master in Engineering, earning a doctorate in electrical engineering in 1973 from the Polytechnic Institute of Brooklyn. Upon graduation, he joined RCA Corporation's David Sarnoff Research Center, conducting research in the field of microwave semiconductors, which culminated in his development of the first high-power compound semiconductor field effect transistor. In 1976, he joined Microwave Semiconductor Corporation (MSC) and established a division to develop and manufacture high-power microwave transistors for commercial and military use. Siemens Corporation acquired MSC in 1981, and Dr. Drukier stayed on as corporate vice president until 1983, when he ventured into a career in real estate.

Dr. Drukier has served on the Weill Cornell Board of Overseers since 2012, sat on Cornell University's Board of Trustees for eight years and was a member of the Cornell Tech Task Force to help develop the Cornell NYC Tech campus on Roosevelt Island. He is chair of the council for the Johnson Art Museum at Cornell, chair of the board of trustees building committee of the Parrish Art Museum in Southampton, N.Y., and serves on the Metropolitan Museum of Art's President's Council. Dr. Drukier is vice-chair of the American Society for Yad Vashem and is a member of the Museum of Jewish Heritage's Board of Overseers. He has also published numerous papers and given lectures in the field of microwave electronics and has contributed a chapter to a book on Gallium Arsenide Field Effect Transistors.

Gale Drukier graduated from New York University's Steinhardt School of Culture, Education and Human Development in 1972 with a degree in speech pathology and audiology, later earning a Master of Science ('73) and a Doctor of Education degree ('79) in audiology from Teacher's College at Columbia University. Dr. Drukier began her career as an audiologist at Bellevue Hospital and at Veterans Affairs hospitals in metropolitan New York, later joining Trenton State University — now the College of New Jersey — as a professor. During her 17-year tenure there, Dr. Drukier conducted research, taught and developed the college's nationally accredited graduate program in audiology. She was consistently recognized by her students as the "Best Teacher." After retiring from teaching, Dr. Drukier joined her family's business, BD Hotels, and has managed and renovated properties on Manhattan's West Side for more than 12 years.

Dr. Drukier has continued to serve NYU since her graduation. She has been a member of the Steinhardt Dean's Council since 2005 as a supporter of the educational and fundraising initiatives of the school. In 2007, Dr. Drukier joined the NYU Board of Trustees and presently chairs its Academic Affairs Committee. In 2010, Dr. Drukier endowed and named the deanship of NYU's Steinhardt School of Education. She was awarded the Meritorious Service Award by NYU in 2013.

Dr. Drukier has also been active at Cornell University, chairing the Herbert F. Johnson Museum of Art's Program Committee and is a member of the Plantations Council. Dr. Drukier and her husband endowed the deanship at Cornell's College of Architecture, Art and Planning, endowed the curator of prints and drawings at the Herbert F. Johnson Museum and created a garden at Plantations at Cornell University. The couple is also active in the Parrish Art Museum in Southampton, N.Y., and serves on the Metropolitan Museum of Art's President's Council. Dr. Drukier is an animal lover, particularly of felines, and is on the board of directors of the Animal Rescue Fund of the Hamptons. The Drukiers have one daughter and four grandchildren.

Weill Cornell Medical College

Weill Cornell Medical College, Cornell University's medical school located in New York City, is committed to excellence in research, teaching, patient care and the advancement of the art and science of medicine, locally, nationally and globally. Physicians and scientists of Weill Cornell Medical College are engaged in cutting-edge research from bench to bedside aimed at unlocking mysteries of the human body in health and sickness and toward developing new treatments and prevention strategies. In its commitment to global health and education, Weill Cornell has a strong presence in places such as Qatar, Tanzania, Haiti, Brazil, Austria and Turkey. Through the historic Weill Cornell Medical College in Qatar, Cornell University is the first in the U.S. to offer a M.D. degree overseas. Weill Cornell is the birthplace of many medical advances — including the development of the Pap test for cervical cancer, the synthesis of penicillin, the first successful embryo-biopsy pregnancy and birth in the U.S., the first clinical trial of gene therapy for Parkinson's disease, and most recently, the world's first successful use of deep brain stimulation to treat a minimally conscious brain-injured patient. Weill Cornell Medical College is affiliated with NewYork-Presbyterian Hospital, where its faculty provides comprehensive patient care at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. The Medical College is also affiliated with Houston Methodist. For more information, visit weill.cornell.edu.

This release was updated on Dec. 16, 2014.