Louisiana Is Getting an Unlimited Supply of a $24K Hep C Cure (HBO)

Summary

Damien Belen, a Hepatitis C patient, faces barriers to treatment due to the high cost of medication. Despite the availability of a cure, Louisiana's Medicaid struggles to cover the costs, leading to creative negotiations with pharmaceutical giant Gilead. The state proposes a subscription-based pricing model to increase access, drawing inspiration from successful strategies in other regions. While the agreement offers a breakthrough, the systemic challenges of high drug prices and the profit-driven pharmaceutical industry remain pressing issues, with many still unable to receive the treatment they need.

Takeaways

• 😀 Damien Belen was diagnosed with hepatitis C at age 12, a chronic disease transmitted through blood, often linked to the opioid epidemic.
• 😀 Hepatitis C (Hep C) is the most widespread infectious disease in the U.S., affecting over 2 million people, with increased rates due to shared needles in the opioid crisis.
• 😀 The Hep C crisis is urgent, as more people die from it annually than from other infections like HIV, tuberculosis, and influenza.
• 😀 In 2014, a groundbreaking drug was introduced, offering a cure for Hep C with a 12-week course of pills, but high costs make it inaccessible for many.
• 😀 Louisiana’s Medicaid system cannot afford to provide the Hep C cure to everyone who needs it, and private insurers like UnitedHealthcare often deny coverage for the drug.
• 😀 The cost of the drug is prohibitive, with patients like Damien unable to afford the $91,000 price tag without insurance or government aid.
• 😀 Dr. Rebecca Key, Louisiana's Health Secretary, explored solutions to make the drug more affordable, including using a 1910 law to bypass patents and negotiate lower prices.
• 😀 The state's proposal to pharmaceutical companies involves a subscription pricing model, where Louisiana would pay a set price for unlimited access to the drug for Medicaid patients and those in prison.
• 😀 If the subscription model is adopted, Louisiana estimates they could treat up to 10,000 patients annually, compared to just 300 under the current system.
• 😀 After years of negotiation, Louisiana reached a deal with Gilead, which would allow the state to access the cure for five years, despite challenges from the for-profit drug industry and limited state funds.

Q & A

What is Hepatitis C, and how is it transmitted?

Hepatitis C is a chronic liver disease caused by a virus that is primarily spread through blood. It can be contracted through sharing needles or through blood transfusions.

How widespread is Hepatitis C in the U.S.?

Hepatitis C is one of the most widespread infectious diseases in the U.S., affecting more than 2 million people.

How did Damien Belen contract Hepatitis C?

Damien contracted Hepatitis C from his mother when he was 12 years old.

What is the current treatment for Hepatitis C, and why is it difficult for some people to access?

The current treatment for Hepatitis C is a pill taken once a day for 12 weeks, which is considered a cure. However, due to its high cost, some individuals cannot afford it, and insurance companies may not cover it unless the patient’s liver is already severely damaged.

Why is Louisiana’s Medicaid system struggling to provide Hepatitis C treatment to all patients?

Louisiana’s Medicaid system has a limited budget and has to ration treatment based on the severity of patients' conditions. The high cost of the medication, which can be as much as $91,000 per patient, exacerbates the problem.

What solution did Dr. Rebecca Key propose to address the Hepatitis C treatment crisis?

Dr. Rebecca Key proposed using an old law from 1910 to take control of the Hepatitis C drug patent, allowing the government to produce the medication at a lower cost. She also suggested a subscription pricing model where the state pays a fixed price for unlimited access to the drug.

What is the subscription pricing model, and how does it work?

The subscription pricing model allows states to pay a fixed price for unlimited access to Hepatitis C medications for Medicaid recipients and inmates. After reaching a pre-negotiated price, any additional spending is reimbursed by the pharmaceutical company.

What has been the outcome of Dr. Key’s negotiation with Gilead, the maker of the Hepatitis C drug?

After extensive negotiations, Louisiana reached a deal with Gilead to provide unlimited access to the Hepatitis C drug for five years, although the state is paying more than before. The deal aims to treat a significantly higher number of patients.

Why is it so difficult to negotiate with pharmaceutical companies like Gilead?

Negotiating with pharmaceutical companies is challenging because they are driven by profit motives. They have shareholders to satisfy, and without significant leverage, states like Louisiana have limited negotiating power.

What is the main obstacle to widespread access to the Hepatitis C treatment in the U.S.?

The main obstacle is the high cost of the medication, which is set by pharmaceutical companies. Policymakers’ reluctance to regulate prices allows these companies to maintain high prices, limiting access to the cure for many people.