The new hepatitis C drugs are expensive. Harvoni costs $1000 per pill for a total of $84000 for treatment. It works well, clearing the virus in over 90% of cases, though the evidence-based medicine purists would still argue there’s no evidence that this improves any patient-oriented outcomes such cirrhosis and death. The drugs haven’t been in existence long enough to know.
Initially, state Medicaid plans did not cover the drug except in very narrow circumstances. In April of this year, even the Massachusetts Medicaid plan severely limited its coverage, but by July reports were that under the threat of a lawsuit, the plan was expanding coverage to all eligible patients. A law professor was quoted, “… states aren’t permitted under the law to restrict access to medically necessary therapies on the grounds that they cost too much.”
This problem isn’t restricted to hepatitis C drugs. According to a study by the AARP, the average retail price of 115 specialty drugs for diseases ranging from cancer to multiple sclerosis to rheumatoid arthritis cost more per per year than the median household income. All of the reports I referenced acknowledge that there are some secret discounts below the listed prices, but they aren’t steep.
Other countries have the maturity and courage to have conversations about the best use of collective resources that always include restrictions on expensive treatments to only those patients who will likely experience significant benefit. Because we don’t have these conversations, our overall healthcare costs will continue to outpace economic growth and wage growth. Yes, there are a few less hepatitis C viruses in the U.S. population now, but we’re all becoming poorer as they disappear.
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