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Hep C Discussion Forum -> Hep C News -> More on the Medicare/Medicaid Problem
Post Info TOPIC: More on the Medicare/Medicaid Problem
OldenSlow


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RE: More on the Medicare/Medicaid Problem
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Tig -  Yes, much of it is understandable given the pressure being placed on state budgets. I certainly wouldn't care to be a state budget director trying to navigate this mess. As you know regarding the older SOC's, they are not an option for some of us.  I shudder to think where I might be in the absence of the coupon copays provided by Gilead and JNJ.  I imagine I would have found some way to make it happen, irregardless, but I gave it a lot of thought prior to approval.  It's disconcerting being forced to place a dollar value on your own life.

I do hope the various states examining this on a case-by-case basis will do so in a fair manner. I fear, however, that funds will be exhausted more sooner than later. Fairness won't matter at that point.

wayne



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66 y/o male - Geno 1b - F4 cirrhotic dx 2001 - 16 wk treatment w/ Sovaldi/Olysio/Riba - Und @ EOT+24 SVR

 
Tig


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Hi Wayne,

That follows the reports I've been reading as well. I mentioned that in a chat with Michaele that the state and federal Medicaid/Medicare allowances were established before the release of these newest DAA's. If the states were to authorize the number of new claims that are coming in for these new drugs, the funding would be exhausted overnight. They are encouraging some doctors to continue to prescribe and recommend the older SOC's (Incivek, Victrelis, Peg and Riba combinations). While their SVR rates and Sx profiles are less attractive than the new wonder drugs, they still are effective options. Perhaps there may even be some considerations on reducing costs to make them more attractive. I wouldn't encourage anyone to refuse the opportunity if offered. The truth of the matter is nobody knows what the future will hold in regards to insurance coverage. I'm afraid it's going to be a confusing journey along a rocky road until we find out where it leads.

Tig



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Tig

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OldenSlow


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From Bloomberg.com   March 4, 2014...

"The new drug has arrived as the 2010 Patient Protection and Affordable Care Act, known as Obamacare, promises to add more than 12 million people to the Medicaid program in a nationwide expansion. At the same time, health-care costs for states continue to grow after doubling to 30 percent of state and local budgets from 1987 to 2012, according to a January report by the Pew Charitable Trusts.

State officials at Medicaid programs in Louisiana, California, Michigan and Florida said in interviews that they will only approve the use of Gilead's Sovaldi on a case-by-case basis while they study how best to address the drug's cost going forward.

In Colorado, officials advised doctors in a Feb. 19 letter that "new therapies for hepatitis C will not be approved" until the state finishes its review."

Full article:

http://www.bloomberg.com/news/2014-03-05/hepatitis-c-drug-price-limiting-state-medicaid-approvals.html

 



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66 y/o male - Geno 1b - F4 cirrhotic dx 2001 - 16 wk treatment w/ Sovaldi/Olysio/Riba - Und @ EOT+24 SVR

 
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