Over the past year, 20 states have eliminated fibrosis restrictions to hepatitis C virus (HCV) treatment, an incredible victory for advocates fighting to expand access to lifesaving medications.

A new report by the National Viral Hepatitis Roundtable (NVHR) and the Center for Health Law and Policy Innovation (CHLPI) tracks the progress, with researchers saying they are pleased at how much has changed since the launch of their first Hepatitis C: The State of Medicaid Access report in October 2017.

According to the findings, 37 states now have no fibrosis restrictions, meaning that patients no longer have to wait until they are sick to access treatment. Nine states have also loosened their sobriety restrictions for Medicaid treatment, and six have scaled back their prescriber restrictions.

“Our collaborative advocacy is working,” the report states. However, both groups say there is still much to be done to further expand access to treatment. For instance, 14 states still require people to have a liver fibrosis score of F2 or higher to access treatment. Twelve states still require patients to be sober for six months before they can be approved for medications, and 33 states still have prescriber restrictions in place, which makes it difficult to access care in rural areas.

In addition to lobbying for Medicaid expansion, advocates are also seeking to eliminate access restrictions in private insurance and state correctional systems, with the goal of one day having open access to treatment for all.