Due to the high cost of hepatitis C medications, some states are restricting access to this treatment.
Under the staggering cost of providing a state of the art drug to combat the deadly Hepatitis-C virus, as many as three fifths of state Medicaid programs have imposed tough restrictions on millions of low income patients and veterans seeking reimbursement for the treatment, which can cost as much as $100,000 for a single course of treatment.
Thirty-three states spent more than $1 billion a year to treat the disease with Sovaldi, according to data released last December by Sens. Charles Grassley (R-IA), and Ron Wyden (D-OR). Remarkably, even at that high level, that money could only treat 2.4 percent of Medicaid patients who were infected with the Hep-C virus.
Although state officials bridle at this being described as pricey drug rationing, many states restrict the use of Sovaldi and Harvoni, the two most effective drugs for treating the disease, to patients with the most advanced cases of liver disease or who can provide certification from gastroenterology or liver transplant specialists that they need the treatment immediately. Medicaid bureaucrats deny the drug to people who continue to abuse drugs or alcohol or who are deemed to have little chance of benefiting from the treatment.
States are saving hundreds of millions of dollars annually by enforcing these drug rationing procedures and say they would bust their budgets if they had to pay for ‘wonder drugs’ to treat every Hep-C patient who applies for prescription drug coverage. Gilead Sciences, which manufacturers both biologic medications, touts cure rates of as high as 95 percent in contrast to 40 percent for less advanced treatments. But Sovaldi and Harvoni can cost between $83,000 and $95,000 retail for a full course of treatment.