Which state you live in can determine whether a patient gets treatment for hepatitis C or not.
When Peyton Howell learned a medicine could cure the hepatitis C that has ravaged his liver since birth, he thought it was too good to be true.
Sitting beside his mom last fall at a doctor’s office in Austin, the 17-year-old had just learned his condition was urgent. Peyton’s liver is on the brink of cirrhosis and getting the drug is his best chance to reverse the damage that can lead to cancer, liver failure and even death.
He left the office with a prescription, but it turns out that Peyton was right to be skeptical.
Texas Medicaid refused to pay for it, then rejected Peyton again when he appealed. The state won’t cover the $75,000 drug until Peyton turns 18 in March, a milestone that also marks the end of his Medicaid benefits.
States concerned with cost have limited which Medicaid patients are eligible for the pricey drugs that cure hepatitis C — the most deadly infectious diseasein the U.S. — only to roll back some of those restrictions after being sued by patients and shamed by doctors.
Texas remains among the most strict, denying the medicine to all but the sickest patients who already have significant liver damage, and those who can demonstrate they have been sober for three months.
Delaying treatment means patients can keep spreading hepatitis C through their blood, by sharing needles or passing it onto their children.
“It is so silly and inconceivable,” said Dr. Jose Luna, who works at an El Paso clinic where nearly a dozen of his Medicaid patients have been denied the drugs because their condition was not yet serious enough. “It’s like someone telling you ‘I have a patient with diabetes, but I’m not going to approve medication until we amputate a foot.’”
Phil Waters, with the Harvard Law School Center for Health Law and Policy Innovation, was more blunt.
“If you wait to treat people, you are perpetuating the spread of this deadly virus,” he said.
The state estimates more than 580,000 Texans may be infected with hepatitis C. Texas Medicaid has spent nearly $155 million on drugs to cure the disease in the last two fiscal years. It’s not clear how many patients the state has denied.
|Read on: Patients get sicker as Texas refuses to cure them of deadly hepatitis C – San Antonio Express-News|