Virginia Medicaid Hepatitis C Therapy Patient Treatment Agreement

Posted On Wednesday, April 14, 2021

While the exact amount of potential savings would vary from country to country depending on the total budget of prescription drugs, the amount of funds would be substantial and potentially useful to meet the medical needs of other Medicaid recipients. This tension is particularly remarkable because public programs face short-term budgetary realities that are at odds with these long-term benefits. For example, the $1.3 billion spent in 2014 by Medicaid programs on sofosbuvir represents access to drugs for only 2.4% of Medicaid recipients who are clinically eligible for treatment.21 Nevertheless, this work highlights problematic elements in the criteria for using medicaid that highlight the need for further studies and evaluations. With respect to HCV treatment, criteria for use should be studied in Medicaid organizations for administered care, and direct studies on the costs and comparative effects for sofosbuvir and other new HCV drugs are also urgently needed. As physicians become more comfortable with the new active ingredients, data on long-term supplier behaviour, clinical outcomes and measures such as dropout rates, which are expected to reach 8% in private insurance markets, will also affect the future Medicaid pharmaceutical policy. The assessment of other direct antiviral agents is also warranted given the rapidly changing landscape of HCV treatment regimens. Many other Medicaid programs (as well as private and other public insurers) have introduced restrictions on health coverage to address significant budgetary problems. However, eligibility criteria can vary considerably.16,17 Between programs with sofosbuvir reimbursement criteria, z.B. the majority restricts use due to substance abuse, serious illness and prescribing criteria16 In some countries, substance users must also demonstrate periods of abstinence before receiving sofosbuvir, and the authorization of HIV-infected patients may depend on their antiretroviral treatment. Although the restriction of access to sofosbuvir among Medicaid recipients has been associated with prolonged substance use and reduced spending, these criteria raise significant concerns regarding medical ethics, clinical evidence and possibly federal law.

Providing HCV treatment to clinically eligible Medicaid recipients is an important public health measure, and policy makers should oppose these requirements under The Medicaid coverage policy and adopt strategies to reconcile short-term budget realities with long-term treatment benefits. sofosbuvir, the first polymerae inhibitor approved by the Food and Drug Administration, Can achieve extremely high hepatitis C (HCV) cure rates of more than 90% with much less toxicity and a shorter duration of treatment than conventional agents.1-4 Easily tolerated tablet, used in combination with other drugs, sofosbuvir is the first in a wave of new anti-HCV drugs that show significant improvements compared to conventional interferon-based therapies.