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Monthly subscription for streaming music?  Sure. Unlimited gym access? Of course. Favorite Netflix shows?  Yep. But hepatitis C treatment by subscription?

Maybe so.

In the state of Louisiana, officials recently released a solicitation seeking a fixed price for an “unrestricted supply” of the direct-acting antivirals that can cure hepatitis C.  A subscription, if you will. Having spent $35 million last year to treat fewer than 1,200 patients, the state is taking a new approach.  

The proposed subscription would allow Louisiana to cap spending on the drugs.  It would also incentivize the winning bidder to treat as many patients as possible, according to the state.  Meanwhile, Louisiana officials have their own treatment goal: Cure 10,000 people by 2020. That’s almost a quarter of the 39,000 people with hepatitis C covered by Medicaid or in Louisiana state prisons.

And Louisiana’s idea may be catching on.  Washington state followed up with a Netflix-style subscription solicitation of its own this month.

While these states deserve credit for proposing a novel payment model, a few questions remain:




Finding viable answers to these questions could free Louisiana, Washington and perhaps other states to follow through with their innovative plan.  

In an age where subscriptions serve everyday needs from grocery delivery to online news access, patients and policymakers alike are eager to see it serve a deeper purpose: curative treatment for a chronic and deadly disease that continues to threaten public health.  

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