With the help of legal battles and lobbying efforts, thousands of people with hepatitis C may get access to treatment with expensive medications.
After legal battles and lobbying efforts, thousands of people with hepatitis C are gaining earlier access to expensive drugs that can cure this condition.
States that limited access to the medications out of concern over sky-high prices have begun to lift those restrictions – many, under the threat of legal action. And commercial insurers such as Anthem Inc. and United HealthCare are doing the same.
Massachusetts is the latest state to decide that anyone with hepatitis C covered by its Medicaid program will qualify for the newest generation of anti-viral drugs. Previously, managed care plans serving Medicaid members often limited the drugs, with a list price of up to $1,000 a pill or more, to people with advanced liver disease only.
The expansion follows a threatened lawsuit against drugmakers by Massachusett’s attorney general, which induced companies to offer the state bigger rebates on the medications, making them more affordable.
Over the past few months, Florida, New York and Delaware have also expanded access in their Medicaid programs. And in April, a federal judge ruled that Washington state couldn’t withhold treatments from Medicaid members with hepatitis C who hadn’t yet developed serious medical complications.
“I think the writing is on the wall for restrictive policies, and plaintiffs are likely to prevail in these lawsuits,” said Nicholas Bagley, a professor of law at the University of Michigan. “These aren’t me-too drugs with marginal benefits: they’re actual cures. While their cost is a huge fiscal problem, states aren’t permitted under the law to restrict access to medically necessary therapies on the grounds that they cost too much.”
Read Full Article: Help with the high cost of hepatitis C drugs
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