The Risky Business of Limiting Medicaid Access to Sovaldi

The Risky Business of Limiting Medicaid Access to Sovaldi

by Chris Kardish | August 19, 2014

Partially because of its high cost, nearly half the states are restricting Medicaid patients' access to an effective new hepatitis C drug. Experts say there’s no question lawsuits will come....

States typically have to cover drugs from makers that participate in Medicaid’s drug rebate program, which includes Gilead Sciences, the company that sells Sovaldi. According to the company, 47 states are covering the drug for their Medicaid populations. But in order to limit its use, about half are enforcing “prior authorization,” essentially creating lists of criteria that patients must meet before a doctor can prescribe the drug. Most commonly those criteria require a patient to be in the worst stage of hepatitis C, which is cirrhosis, and that they be drug-free for a period of time. The goal is to restrict Sovaldi to people who already have severe liver damage, which opponents argue is too late. Among the states limiting Sovaldi are California, Florida, Louisiana and Oregon, which typically have larger Medicaid populations and more patients with hepatitis C....

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Related @ NATAP

Medicaids/ Feds Deny HCV Treatment to Poor/Disenfranchised, Those Most Affected by HCV-

HCV Restrictions New Meeting Dec 18, 2014 by California Panel (CTAF) That Previously was the 1st to construct absurd restrictions .....the CTAF meeting in March 2014 was the 1st "kangaroo court" to restrict HCV treatment access, it appeared rigged as all these efforts are, they are not in the best interests of patients/marginalized patients and are opposite of the spirit of Medicaid & federally funded healthcare...they say - HCV treatment is too expensive...we can't treat everyone....we will construct restrictions that in affect deny access to drug users & treat only those with advanced disease

American ingenuity can make it happen

Sovaldi represents great pharmaceutical innovation. Results have been exceptional. Unfortunately, the drug's maker — taking advantage of a lack of competition fostered by patent protection — has priced it so high as to be a major threat to health care affordability.

Updated August 20, 2014 

Reducing the cost of new hepatitis C drugs
An index of articles pointing the reader to the current controversy over the high price of Sovaldi