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PA Medicaid to Expand Access to Hep C Drugs

Pennsylvania’s Medicaid program will make treatment for hepatitis C more readily available to Medicaid beneficiaries beginning on July 1, state officials have announced.
In recent years, new drugs have become available that effectively cure hepatitis C but their exceptionally high costs led many insurers, including most state Medicaid programs, to limit access to those drugs until patients show more advanced signs of the disease.  A year ago the Pennsylvania Department of Human Services’ pharmacy and therapeutics committee recommended expanding access to these drugs for Pennsylvania Medicaid beneficiaries and now, that recommendation has been adopted and that expansion will begin with the new state fiscal year on July 1.
Under the new criteria, patients with lower scores of severity of hepatitis C will become eligible for treatment.  Previously, Medicaid patients were required to show more advanced signs of illness before the medicine was provided to them.
Learn more about the Pennsylvania Medicaid program’s revised approach to serving Medicaid patients with hepatitis C in this Philadelphia Inquirer article.

2017-05-18T06:00:32+00:00May 18th, 2017|Pennsylvania Medicaid policy|Comments Off on PA Medicaid to Expand Access to Hep C Drugs

Study: Medicaid Denying Expensive Hepatitis C Drugs

A new study has found that state Medicaid programs are rejecting nearly 50 percent of requests to administer expensive hepatitis C drugs to patients.
According to a review of prescription data for Pennsylania, Delaware, Maryland, and New Jersey, 46 percent of requests for such treatment for Medicaid patients were denied. Only five percent of similar requests were denied for Medicare patients and 10 percent for those with private insurance.
Prescription Medication Spilling From an Open Medicine BottleThe study represents the first documentation of a concern raised when the expensive drugs first hit the market: that insurers would limit access to them.
The U.S. Department of Health and Human Services recently sent letters to state Medicaid programs expressing concern about the possible denial of expensive prescription drugs to Medicaid patients.
For more information about access to hepatitis C medicine and the recently completed study, see this Philadelphia Inquirer article.

2015-11-20T06:00:54+00:00November 20th, 2015|Pennsylvania Medicaid policy|Comments Off on Study: Medicaid Denying Expensive Hepatitis C Drugs
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