After eyeing the high price tag of Sovaldi (sofosbuvir) and Olysio (simeprevir), two of the latest and most effective cures for the hepatitis C virus (HCV), Oregon health officials say they are hoping to limit routine coverage of the drugs for its state-funded health insurance program, Oregon Live reports.
State officials say treating just one-third of the nearly 20,000 people living with hepatitis C on the Oregon Health Plan (OHP) would cost the state nearly $168 million a year, with treatment courses adding up to $84,000 per person. They argue that the cost of treating just a small portion of those living with the virus could potentially devastate the state’s health care budget and draw money away from patients with cancer, diabetes and other serious illnesses.
Although most other states are now required to cover the drugs under their Medicaid programs, Oregon has a special waiver exempting it from the law. Thus, the state is legally able to deny routine coverage of certain drugs on its state exchanges based on cost and efficacy issues.
The decision has not gone through yet, and it must ultimately be decided on by OHP’s Health Evidence Review Commission, a process that could take months.
To read the full Oregon Live report, click here.
Oregon Hopes to Limit Insurance Coverage of New Hep C Meds
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