2014 Hep C Sovaldi sticker shock for insurers

The Kaiser Family Foundation (KKF) has published several articles of interest to Asknod members.  

One April 14 headline reads:  Biggest Insurer Shocked with Hepatitis C Costs.  

Quote: “United Health Group spent $100 million on hepatitis c drugs in the first three months of the year, much more than expected, the company said Thursday.” 

Uh-oh.  High demand and 80K plus per patient in costs have insurers stock costs dropping.   Well, they’ve tried to keep the lid on this disease for decades and now it’s off. 


If only we could have covered up and ignored HCV a little longer…

KKF links to this VA March 27, 2014 38-page document for providers.  It details a “preferred treatment approach” for HCV by genotyping and other factors for “patient selection.”  It’s clear that VA hepatologists  and experts have been working hard on this strategy to deal with all the newly diagnosed veterans.  They have lots of studies and rationales to back up who gets what and when to manage their HCV crisis.

This article,VA, California panels urge costly drugs for sickest Patients, links to the new WHO 124-page  (April 2014):Guidelines for the screening, care and treatment of persons with hepatitis C infection

Unless the cost of the new drugs are drastically reduced, widespread rationing can be expected.  HCV patients will be stigmatized further as undeserving greedy people who…

  • dare seek a cure at the expense of the innovative drug researchers (who deserve their high-living wages for staying up all night in the lab), and
  • keep our altruistic health insurance CEOs up at night with worry, and
  • who torment the generous House members who fund the VHA’s budget.  By golly, we won’t let HCV-veterans defeat our great nation by breaking the bank! 

This is going to be hard for veterans who suffer from the largest cluster of HCV-infections deniedin America by far, because the VHA does not currently have the funds available to treat everyone, other government programs may not be much better off, and private insurers are beginning to panic.  I suspect that patients, including veterans, co-infected with HIV/HCV, will be more likely to get the new antivirals because of existing public policies. But what about the majority who may find themselves with nowhere to turn?



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8 Responses to 2014 Hep C Sovaldi sticker shock for insurers

  1. ray says:

    I wrote Bernie sanders in D.C. to see if and when the VA will be dispensing the cure drug HARVONI…….still waiting for his reply.

  2. SPrice says:

    Perhaps we should do what Brazil did. They formally accused the Ministry of Health of discrimination against Hep C patients (see link). They started off by saying that 4 years ago the Hep C program was integrated into the existing HIV program, both managed by the same people and both supposed to be equal. “Without privileges to any person or disease” according to the NHS. However, drugs for the treatment of AIDS are classified as “strategic medicines” and are easy to obtain while Hep C meds are considered “Specialty drugs ” and the process to obtain them is complicated and time consuming and may result in denial or treatment being delayed by up to a year. Clearly showing discrimination against Hep C patients.

    A friend of mine wrote it. He says we can borrow it.

    For translation of the document see….

  3. The doctor wants to start me on treatment and the slot is there BUT he wants as many of the related problems fixed first. He has ordered, and I have begun, seeing GI, Urology, Kidney specialists etc. With a stroke of his magic wand I am seeing more doctors in a few months than I have in the past eight years. The VA is approx. 49 miles away but the medicine is rationed out for two week periods and serious follow-up. Now if I can just get this pesky fog, encephalopathy, to blow East I can start treatment.

    • Kiedove says:

      This sounds promising for you. I think they should not be overly slow about getting you in the program.

  4. asknod says:

    Color me one of them. VA says wait until next May when we have funding. Medicare says gimme $3K a month for two months and then $9 K/month until you bridge the donut hole (3 months). Lastly, one last month of $3 K. Problem solved. Let the patient pay for it with the new Obamacare formula or… euthanasia by inaction, baby!

  5. Clear Left says:

    Appears this is going to be another case of ‘Delay, Delay….’

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