This case series describes the safety and effectiveness outcomes of patietns requiring HCV DAA tablet manipulation. This data along with a comprehensive review of other reports of DAA manipulation demonstrate the safety and efficacy of tablet manipulation.

This study's findings indicate that access to DAAs in donor-derived HCV post-transplant is achievable and affordable; however, 35% of patients required an insurance appeal requiring significant administrative efforts. Additionally, patients not able to use the on-site specialty pharmacy and those requiring an insurance appeal were 5.8 and 5 times more likely to experience a delay in treatment initiation.