Louisiana Strikes Deal Broadening Access To Hepatitis C Drug

Jul 2, 2019
Originally published on July 2, 2019 2:23 pm

Louisiana has struck a deal with a pharmaceutical company to provide Hepatitis C treatment to the state's Medicaid patients and prisoners.

The five-year deal is the first of its kind in the nation.  The subscription model will give the state an unlimited supply of the drug, while putting a cap on the price.

On this week's Capitol Access, WRKF's Wallis Watkins talks with Dr. Rebekah Gee, Secretary of the Louisiana Department of Health.

Q: Can you begin by telling me a little bit about this disease and what it takes to treat it?

Sure, so Hepatitis C kills more Americans than all other infectious diseases combined.  When you think 'infectious disease,' think flu virus, HIV, anything that you can get from someone else.  We have a drug that is a single pill-a-day regimen that has a greater than 95% chance of curing someone.  When the drug first came out, it was in the $90,000 range and over time that price has come down, but it's still the cost of a car.  When you think of the at least 37,000 people on Medicaid and even more if you add in the correctional system, it's tens of thousands of people with a very expensive illness, but the price was a real problem.  When we looked at trying to cure everyone with this disease in Louisiana, for Medicaid alone it would have cost over $750 million, and that was more than our K-12, Correctional and all administrative functions of government spend combined.

Q: The federal government recently approved a new method for the state to pay for the drugs to treat Hepatitis C.  The state will pay a fixed amount of money to the drug maker over the next five years and in exchange, the state gets as much of the drugs as it needs.  Through this deal, medication will be made available to the state's Medicaid patients and the state's prisoners.  How many people in that population have Hepatitis C?

In Medicaid, it's at least 37,000 people, and those are just the numbers we know.  We don't have universal testing, so we estimate it's much more than that.  In the correctional system, we don't know.  We haven't had the resources to treat people in the correctional system.  We will start focusing on people who are in the state correctional system, not local jails, but plan to move to individuals in local jails over time as we figure out this system.

Q: It sounds like the state is going to be able to broaden the number of people who are getting access to this treatment as a result of this deal.  What does access to the drug currently look like?

Last year, of the 37,000 people in Medicaid, we were able to treat just a little over 1,100— so less than 3% of people are getting treated.  And in the correctional system, it's less than 1%.  This is an unique opportunity in a short period of time to have access to unlimited drug, so we want to take advantage of that by making sure that everyone who has the virus gets treated and cured.

Q: Zooming out a bit, what does this plan potentially mean for the effort to try and rein in the cost of prescription drugs?

This is an example of a voluntary model that did not require federal regulation, where the company and the state of Louisiana came to an agreement without the federal government putting constraints on the price or passing a law to require transparency.  All of us know that drug prices are too high.  This is one solution for a very big problem, but Americans need a variety of solutions and we need to continue to support the innovative pharmaceutical industry while also recognizing that there are some abuses, and as policy makers, we need to address those.

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