The Hepatitis C Health and Pricing Crisis

Yesterday, the Centers for Medicare & Medicaid Services (CMS) announced that it will cover hepatitis C screenings for Medicare beneficiaries who are at high risk of being infected or meet other criteria. Health plans’ top priority is helping patients get the care they need, and we welcome this announcement. These screenings are an important part of giving patients with hepatitis C the best shot at living a healthy life. The United States is facing a public health crisis with this disease, and it’s important that all stakeholders work together to fight it.

We alone cannot solve this challenge when unsustainable drug prices threaten access to life-saving treatments. Sovaldi, the blockbuster drug to treat hepatitis C, has shown tremendous results. But at $1,000 a pill, the crushing costs will put the drug out of reach for too many patients who need it. As Bloomberg News has noted, “If everyone in the U.S. with hepatitis C were treated with Sovaldi at its list price, it would cost $227 billion compared with the estimated $260 billion spent a year in the country for all drugs.”

The decision by CMS is an significant step in fighting hepatitis C, but to ensure patients can access this important drug, all stakeholders need to come together to find a sustainable pricing solution.

Check out AHIP’s latest Innovations report to learn more about health plans’ efforts to support Medicare and Medicaid beneficiaries facing chronic conditions.

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