More bad news for hep C drug pricing

February 15, 2016

A new report found that the majority of state Medicaid programs cannot afford hepatitis C medications, such as Harvoni and Sovaldi (Gilead Sciences), which can cost nearly $100,000 for a single course of treatment.

The majority of state Medicaid programs cannot afford hepatitis C medications, such as Harvoni and Sovaldi (Gilead Sciences), which can cost nearly $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 by Senators Charles Grassley (R-Iowa), and Ron Wyden (D-Ore.). That meant that only treat 2.4% of Medicaid patients who were infected with the hep C virus could be treated, according to a new report from The Fiscal Times.

This is just the latest bad news for hepatitis C drug manufacturers, including Gilead and AbbVie (which makes Technivie and Viekira Pak), after Congress recently held hearings on high drug prices and Democratic presidential candidate Hillary Clinton has made the issue a key part of her platform.

Related: Hepatitis C pricing heats up with new drug

However, there was some welcome news for hepatitis C patients recently when Merck said it would set a list price of $54,600 for a 12-week regimen of its new drug, Zepatier. “Merck anticipates that this price, as well as our comprehensive access strategy to seek broad coverage across commercial and public segments, will help broaden and accelerate patient access to treatment and move us closer to our shared goal of reducing the burden of chronic HCV in the U.S.,” according to a company statement. 

Meanwhile, in the Medicaid program, many states restrict the use of Sovaldi and Harvoni 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, according to The Fiscal Times.

Related: 

FDA expands use of hep C drug

“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,” the publication wrote.

However, advocacy groups have filed class action suits in Indiana, Massachusetts, Minnesota and Pennsylvania, arguing that state Medicaid programs are obliged by law to cover the medication of any low-income person seeking the medical treatment, The Fiscal Times wrote. 

Read more: Hepatitis C drugs come under fire again