U.S.: New Medi-Cal rules ease access to hepatitis C drugs

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California’s revised eligibility rules for hepatitis C drugs appear to be easing Medi-Cal patients’ access to the highly effective medications, according to state data. Yet even with the relaxed guidelines, the vast majority of those on Medi-Cal with hepatitis C still aren’t getting the costly drugs, state health officials say.

When the first of the new class of hepatitis C medications were introduced in late 2013, only the sickest people on Medi-Cal could access them. The state Department of Health Care Services had determined that Medi-Cal members needed to have severe liver scarring or cirrhosis to be eligible.

“Our doctor here would say, ‘you’re almost dead but not dead yet, and that’s how we’re getting you approved,'” recalls Samuel Gonzalez, who oversees the hepatitis C program at the nonprofit St. John’s Well Child and Family Center.

The state revised its hepatitis C treatment policy in July 2015, expanding eligibility to hepatitis C patients with light liver scarring.

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