Delaware state health officials have agreed to change the state’s Medicaid guidelines to make it easier for patients to get Hepatitis C medicine.
The move comes as a result of a demand letter sent to Delaware state officials by the Center for Health Law and Policy Innovation (CHLPI) at Harvard Law School, as well as other attorneys from Delaware and Washington, DC.
Delaware Will Cover All Hepatitis C Patients by 2018
To avoid being sued, Delaware’s Medicaid officials changed the state’s policy to provide medicine for a wider variety of Hepatitis C patients, starting on July 1, 2016.
The initial policy states that if the patient has a “medical necessity” caused by Hepatitis C, then Medicaid will cover the medicine prescribed for it. Symptoms that create a medical necessity include mental changes, arthritis, jaundice, HIV, lymphoma, or fast-growing liver damage.
Delaware intends to gradually expand Hepatitis C medicine approvals until January 1, 2018, when all Hepatitis C patients will be covered regardless of medical necessity.
What is Hepatitis C?
Hepatitis C is an inflammation of the liver resulting from infection by a specific virus (HCV). HCV can only be contracted by being exposed to the blood of an infected person, such as through transfusions, needle sharing, or from an infected mother to her unborn child.
Hepatitis C can arise from six different strains of HCV, making it difficult to treat because some strains of the virus have become immune to certain medicines.
HCV can survive for about three weeks outside the body. It can flare up as a short-term illness or as a chronic disease that lasts a lifetime, possibly causing cirrhosis or liver cancer.
Hepatitis C Medicine Prices Are Astronomical
Hepatitis C medicines are extremely costly. Sovaldi (sofosbuvir), a drug manufactured by Gilead Sciences can cost up to $84,000 for its 12-week treatment. A two-drug combination treatment, Harvoni (ledipasvir/sofosbuvir), costs $94,500 for 12 weeks.
Delaware’s Medicaid program paid out $2.5 million for Hepatitis C medicines in 2014. A growing heroin epidemic in the state has brought about an increase in Hepatitis C cases. Hopefully the new state guidelines will provide faster, better treatment for those who need it.
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