Due to successful legal battles and lobbying efforts, a growing number of people with hepatitis C virus (HCV) infection are gaining access to expensive treatment.
After legal battles and lobbying efforts, tens of thousands of people with hepatitis C virus (HCV) infection are gaining earlier access to expensive drugs that can cure the disease. States that limited access to the medications out of concern over their sky-high prices have begun to lift those restrictions—many under the threat of legal action, according to a report from Kaiser Health News. And commercial insurers, such as Anthem Inc. and United HealthCare, are doing the same.
Massachusetts is the latest state to decide that anyone with HCV infection covered by its Medicaid program will qualify for the newest generation of antiviral drugs. Previously, managed care plans serving Medicaid members often limited use of the drugs, which have list prices of up to $1,000 a pill or more, to people with advanced liver disease.
During the past few months, Florida, New York, and Delaware have also expanded access to costly hepatitis C drugs in their Medicaid programs. And in April, a federal judge rules that Washington state couldn’t withhold treatments from Medicaid members with HCV infection who hadn’t yet developed serious medical complications.
The problem for states that are lifting restrictions: how to offset the expense of covering thousands of patients who may now come forward for HCV treatment. “We want to give these medications to everybody who needs them, but with the prices they’re commanding, something has to give,” said Matt Salo, executive director of the National Association of Medicaid Directors.