Hepatitis C Drug Pricing

Hepatitis C is a lethal and contagious infection causing a public health crisis in Louisiana. About 30,000 people in Louisiana's Medicaid program and prison system are carrying Hepatitis C. Nationally, Hepatitis C is the infectious disease that kills the most people annually, and rates of new infections are growing dramatically as a result of the opioid epidemic.

The state cannot afford to treat large numbers of patients at current drugs prices. Because of the high cost of the drug, less than 3% of people were treated for Hepatitis C in Medicaid last year. Therefore, the Department is pursuing innovative payment models which will enable the state to dramatically expand access to the drug and eventually eliminate Hepatitis C as a public health problem.

The Louisiana Department of Health requested input on the creation of a subscription-based payment model for Hepatitis C medication. Under this payment model, the state would pay a drug manufacturer or manufacturers for unlimited access to the treatment for the individuals in Louisiana who are enrolled in Medicaid or in Louisiana’s correctional system. The payment to the manufacturer would be equal to or less than what the state is currently spending to provide the antiviral medication to these populations.

The complete Request for Information can be found here: www.ldh.la.gov/assets/docs/SPM_RFI.pdf. The deadline for comments was August 24, 2018. For questions or to submit a late response to the Department's Request for Information contact Pete Croughan at pete.croughan@la.govwith “HCV RFI” in the subject line. 

From August 7th to August 24th, the state sought public comment on this approach. There were 13 responses, including responses from healthcare providers, payers, the pharmaceutical industry, and others. The comments include support from a broad range of perspectives. Click here to review the complete comments.

The next step is for Louisiana to develop the subscription model in greater detail with the Centers for Medicaid and Medicare Services. The Louisiana Department of Health is committed to transparency as this process moves forward. If waivers under the Medicaid program are required, these will be posted for public comment before submission to the federal government.

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