Louisiana and Washington state are trying a new way to fight the rise of hepatitis C among Medicaid recipients and prisoners: a Netflix-style model in which the states pay a flat fee for an unlimited supply of drugs to treat the liver disease. Washington also plans to supply the drugs to state employees, retirees and teachers, Michael Ollove reports for Stateline.
"The new design illustrates how states are trying to think creatively to tackle one of their costliest but most important long-term challenges: providing health care access to low-income residents and people in the state’s care," Ollove reports.
Hepatitis C is a growing threat in rural areas, often spread by opioid users who share needles or engage in risky sexual behavior while under the influence. Nationwide, it kills more Americans each year than any other infectious disease, Ollove reports. About 2.4 million Americans had the disease in 2016, according to the federal Centers for Disease Control and Prevention, and many of them aren't aware they're infected.
"In the Washington model, the winning bidder would provide the drugs until 2023 for a set treatment course price up to a total maximum each year, about the $80 million the state spent last year," Ollove reports. "Once that maximum is reached, the manufacturer would provide the drugs for a negligible amount, perhaps as little as pennies per course of treatment."
"The new design illustrates how states are trying to think creatively to tackle one of their costliest but most important long-term challenges: providing health care access to low-income residents and people in the state’s care," Ollove reports.
Hepatitis C is a growing threat in rural areas, often spread by opioid users who share needles or engage in risky sexual behavior while under the influence. Nationwide, it kills more Americans each year than any other infectious disease, Ollove reports. About 2.4 million Americans had the disease in 2016, according to the federal Centers for Disease Control and Prevention, and many of them aren't aware they're infected.
"In the Washington model, the winning bidder would provide the drugs until 2023 for a set treatment course price up to a total maximum each year, about the $80 million the state spent last year," Ollove reports. "Once that maximum is reached, the manufacturer would provide the drugs for a negligible amount, perhaps as little as pennies per course of treatment."
Louisiana would cap the amount it spends on antivirals to $35 million for five years, the amount it spend in 2018. The winning bidder would agree to provide all the needed antivirals to the state for that amount, Ollove reports.
It's unclear if the subscription model will work. Bids for the project are not yet due, and while it's unknown whether any of the major manufacturers of hep C drugs are interested, Ollove reports that they've submitted "detailed questions" to both states about the plans.
"Even if Washington and Louisiana officials aren’t able to negotiate better prices through the Netflix model, health officials said it will offer more certainty about how much the states spend to treat hepatitis C from one year to the next," Ollove reports. States are obligated to provide medications required to treat the disease to the poor and prisoners, according to recent court rulings in several states. It can get expensive. Kentucky, which has the nation's highest rate of new hep-C infections, spent $83,673 per case in the 2015-16 fiscal year.
It's unclear if the subscription model will work. Bids for the project are not yet due, and while it's unknown whether any of the major manufacturers of hep C drugs are interested, Ollove reports that they've submitted "detailed questions" to both states about the plans.
"Even if Washington and Louisiana officials aren’t able to negotiate better prices through the Netflix model, health officials said it will offer more certainty about how much the states spend to treat hepatitis C from one year to the next," Ollove reports. States are obligated to provide medications required to treat the disease to the poor and prisoners, according to recent court rulings in several states. It can get expensive. Kentucky, which has the nation's highest rate of new hep-C infections, spent $83,673 per case in the 2015-16 fiscal year.
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