Across the country, state Medicaid programs are improving patients’ chances of being cured of hepatitis C. If more states follow suit, the deadly virus could be eliminated this decade.
Every state now has treatment criteria. And since 2017, many states have relaxed or lifted barriers to treatment that were originally put into place to minimize costs. Of note:
- 32 states have eliminated requirements that patients have advanced stage liver disease before getting curative treatment
- 21 states have loosened sobriety requirements, which required patients to remain drug free to qualify for treatment
- 25 states scaled back restrictions that allowed only specialists to prescribe hepatitis C cures, allowing more clinicians to cure their patients.
Additionally, seven states, including California, Indiana, Wisconsin and most recently Michigan, have removed all treatment restrictions. They’ve also eliminated requirements for prior authorization.
Progress is due in part to action from the Centers for Medicare and Medicaid Services. In 2015, the agency warned states that they might be violating federal law by restricting access to hepatitis C treatments. Officials also described the direct-acting antiviral medications as “medically necessary.” State Medicaid programs are required to pay for medications with this designation.
These are important steps forward because hepatitis C remains the deadliest infectious disease in the nation. Affecting about 2.4 million people, hepatitis C annually kills more Americans than all other infectious diseases combined – even though direct-acting antiviral medications have close to 100% cure rate.
The medications can, however, be expensive.
Some states, including Washington and Louisiana, have been able to cut costs and expand access by implementing a “subscription pricing” model. The value-based strategy allows states to secure an unlimited amount of medication at a set price. If more states adopt this strategy, access to treatment for hepatitis C patients could be significantly expanded.
With the coronavirus pandemic contributing to a 50% reduction in hepatitis C testing, it’s more important than ever for states to resume outreach efforts so patients can begin treatment. And for states who have yet to reduce access barriers, now is the time. By following the lead of states on the forefront, these states can help make the promise of a cure a reality for all.