What's Preventing Access to New Hepatitis C Meds?

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Hep blogger Lucinda Porter writes about the harsh and unfair practices that prevent access to the new and effective hepatitis C medications

Since 2007, more people have died every year from hepatitis C than from HIV. Fortunately, the latest hepatitis C medications can cure nearly everyone in a relatively quick, easy fashion. So, if it is so easy to cure hepatitis C, why haven't we?

Ostensibly, it is because of the cost. At $1,125 a pill for Gilead Sciences' drug Harvoni, a 12-week course of hepatitis C treatment would amount to $94,500. Trying to manage these costs, many state Medicaid programs and insurance companies have severely restricted access to treatment. You save money if you deny treatment to people, and dead people cost nothing.

This means that although we can cure hepatitis C, we aren't. Under many insurance plans, patients have to prove that they have cirrhosis. In short, treatment is approved when liver damage has progressed to its worst stage. It is like refusing to pay for diabetes drugs until the patient is blind or minus a few toes.

In addition to proof of cirrhosis, insurers create hurdles that require mountains of paperwork and patience. Some require documentation that patients have abstained from alcohol and drugs for six months to a year prior to treatment. If substance use is recent, patients must be actively participating in treatment for the disorder. This practice is not required for cancer or diabetes patients. Imagine if your doctor said to you, "We can cure your cancer, but your insurance won't pay for treatment because marijuana showed up on your tox screen."

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http://www.hepmag.com/articles/talk_about_hepatitis_2502_27823.shtml