Boston Globe
The long-term health prospects for thousands of Massachusetts residents are about to improve. As of Monday, MassHealth will require private insurers that manage coverage for two-thirds of the state Medicaid plan’s members to loosen rules that cruelly prevent people infected with hepatitis C from receiving drugs that cure the disease. Until now, these low-income patients have been forced to wait until they are suffering from potentially deadly symptoms before getting a prescription for one of a new generation of medicines that kills the liver-ravaging virus in as little as eight weeks.
The insurance company restrictions were a misguided reaction to the cost of the breakthrough treatments for hepatitis C, a disease which previously could only be kept in check — but not cured — by drugs that came with terrible side effects. When Gilead Sciences Inc.’s Sovaldi became the first of the more effective medicines to hit the market, in 2013, its $84,000 list price — $1,000 a pill — caused sticker shock for payers nationwide. Fearing their budgets would be drained by a rush of people who wanted to get well instead of living with uncertainty, many insurers limited access to Sovaldi. Even from a cold-blooded accountant’s perspective, it was a foolish policy — providing months or years of medical care for someone suffering from cirrhosis costs much more.
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