by Amanda Conschafter, blog editor
New cures have stirred high hopes for the millions of Americans infected with hepatitis C. But complex insurance and governmental program requirements limit patients’ access to the breakthrough therapies in an effort to contain costs. In its first white paper, the Alliance for Patient Access’ Hepatitis Therapy Access Physicians Working Group explores the value of hepatitis C cures—and the questions policymakers must answer to make these cures available to patients.
As “Improving Patient Access to Hepatitis C Cures,” points out, treating hepatitis C costs the United States an estimated $6.5 billion annually. Much of that cost stems from care for advanced liver diseases such as cirrhosis and liver cancer. Costs are expected to rise as more baby boomers – a group at high risk for hepatitis C – are diagnosed with hepatitis C in the coming years.
Past treatment consisted primarily of regular interferon shots but resulted in significant side effects for many patients. New cures introduced since 2013 are taken in pill form and cause far fewer side effects. Though costly, they result in a 90-99 percent cure rate for most patients.
However, insurers and state Medicaid systems argue that they cannot afford these cures for all patients battling hepatitis C, so they have erected several barriers to access, including:
- Extensive prior authorization processes
- Medication for only the sickest patients
- Liver scan requirements
- Prohibitions against substance abuse diagnosis or treatment
- High co-pays.
To help patients overcome barriers such as these and access the cures they need, the white paper explains, policymakers must consider several questions:
- What are the societal benefits of curing and preventing the spread of hepatitis C?
- How can we structure sustainable insurance systems that also allow patients to get the treatments they need?
- Will competition among different medication manufacturers lead to reduced prices?
- How can we develop insurance co-pays so that patients can afford the treatments they need?
- How can we ensure that hepatitis C patients will take their medications as prescribed?
Read “Improving Patient Access to Hepatitis C Cures” to learn more.