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State reverses restrictive policy on hepatitis C drugs

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The state of Missouri is reversing course and will allow anyone on Medicaid with hepatitis C to receive the medication that cures the disease.

The change in policy comes after a lawsuit was filed against the department that oversees the state’s Medicaid program, arguing that some Medicaid patients were denied medically necessary treatment.

The case, filed in federal court in Missouri’s western district last year, was dismissed Monday following the state’s decision to change its policy, effective Nov. 1.

“We are glad that Missouri health officials will start to ensure that Medicaid enrollees receive these medications in a timely manner. This therapy is not only medically necessary for the individual patient, but it is vital in helping to halt spread of a communicable disease,” Abigail Coursolle, an attorney with the National Health Law Program, said in a statement released Tuesday.

Coursolle, along with the Legal Services of Eastern Missouri and the St. Louis University Legal Clinic, represented the three plaintiffs in the case, all unnamed Medicaid recipients with hepatitis C.

In an attempt to curb spending on the costly medication, a serious budget concern for many states, the department implemented the policy that allowed only the sickest of Medicaid recipients with hepatitis C to receive the new treatments.

Initially, the price of the treatment was $93,000 for a 12-week course of the medication, according to a statement from MoHealthnet, the state agency that oversees the Medicaid program.

It’s estimated that 13,000 Medicaid recipients in the state have hepatitis C, according to court documents.

The price of the drugs has since declined, the state said in a statement.

Hepatitis C is an infectious disease that can lead to liver failure or death. An estimated 3.9 million individuals across the country have the disease, according to the Centers for Disease Control and Prevention.

“This will actually save the state money in the long run,” John Ammann, one of the attorneys for the plaintiffs, told the Post-Dispatch.

“A poor person on Medicaid, their liver gets worse and worse, Medicaid would have paid for a liver transplant. But we don’t have that expense if they’re cured,” he said.

Samantha Liss • 314-340-8017

@samanthann on Twitter

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