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The Real Cost of Hepatitis C Medications

The cost to treat hepatitis C infection can be quite high. Four patients share how much they personally paid out-of-pocket to cure their hepatitis C.

Newer medications have made a dramatic difference in treating hepatitis C, and for many patients, a cure is possible for the chronic viral disease. If left unchecked, hepatitis C can lead to scarring of the liver, liver cancer, organ failure, and the need for a liver transplant.

But some of these drugs come at staggering prices. Here, four patients with hepatitis C reveal how they manage to pay for the full course of treatment for these life-changing medications.

Terl Gleason, 53, Income Tax Specialist

Unassisted Cost: $105,000

Net Out-of-Pocket Tab: $15

Terl Gleason, 53, of Greensboro, North Carolina, started the hepatitis C medication Viekira Pak in February 2015, soon after its approval in late 2014. This combination of drugs includes ombitasvir, paritaprevir, ritonavir, and dasabuvir and can be given with or without ribavirin, depending on a specific patient’s needs. Without financial assistance or insurance coverage, Gleason’s tab would have been $105,000 for the full Viekira Pak treatment course, but in the end he only had to pay $15 total.

“I have Cadillac insurance,” Gleason says, though he does pay a hefty monthly premium for his top-shelf plan: $830. Unlike many other patients, he didn’t have hassles over coverage, as his insurer took care of that. But he did have issues getting access to treatment.

His best tips: “Persistence is the first thing you need,” Gleason says. Be prepared to spend time on the phone. You may have to talk more than usual with your doctor, insurance company people, or those who handle insurance at your workplace. You can help speed matters along by making sure the pharmacy has all the information they need from your doctor, he advises.

Once you’re taking the medication, he says, “Don’t overlook the pharmacist as a source of information. The pharmacist gave me so much information [about the drug].”

Rick Nash, 29, Blogger

Unassisted Cost: About $188,000

Net Out-of-Pocket Tab: About $6,600

Rick Nash of San Diego was diagnosed with hepatitis C at age 12. Now 29, he’s an avid hep C blogger. In the spring of 2015, he took Harvoni (a combination of ledipasvir and sofosbuvir), a daily hepatitis C medication that costs more than $1,000 a pill. He needed one pill a day for 24 weeks.

Luckily, Nash also has what he calls a ‘Cadillac insurance’ program through Covered California, the state’s health insurance exchange. While that helped bring the price down, his out-of-pocket costs were still around $6,600 overall. Unfortunately, Harvoni didn’t work for him — an experience he’s had with other treatments. But he plans to start another treatment plan soon.

His best tips: A few things have helped him along the way. “First, line your ducks up in a row,” he says. “Make sure your insurance covers as much as possible.”

If you’re changing plans, look at each plan’s specialty medicine list to be sure your medicine is there. If not, know that you may be able to get an exception to the formulary (the list of approved medicines on a specific plan.

Read Full Article: The Real Cost of Hepatitis C Medications | Everyday Health

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