Vermont: Advisory board urges expanded access to hepatitis C drugs

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This is in Vermont. What about BC? What about Canada? When are we going to do the right thing – CD

An advisory board says the state should make it easier for Vermont’s Medicaid patients to get access to expensive prescription drugs that treat hepatitis C.

The Medicaid Drug Utilization Review Board, an advisory panel, voted Dec. 6 to lift certain restrictions that make it harder or impossible for some Medicaid patients with the disease to get specialty drugs.

The Department of Vermont Health Access, which administers Medicaid, will need to decide whether to accept the board’s changes. The department has historically set strict restrictions on the drugs because of their high cost.

Steven Costantino, the commissioner of the Department of Vermont Health Access, said in February the cost of the drugs is “a critical concern” to the state from a financial perspective and “kind of an ethical dilemma” for people running state Medicaid programs.

He was not available for comment this week.

In 2015, the state spent $11.9 million to buy the hepatitis C drug Harvoni, and it spent $3.3 million in 2014 on Sovaldi, another hepatitis C drug, according to a VTDigger investigation. While the state eventually received rebates for both of those drugs, they are widely considered some of the most expensive drugs on the market.

But the board says the Department of Vermont Health Access should pay for more Medicaid patients to get the hepatitis C drugs, including patients who have stage 2 liver disease. Currently, the department restricts the drugs to only people whose liver disease has progressed to stage 3 or 4, who often already have irreversible liver scarring.

The department also says patients can get the hepatitis C drugs only if they have not used drugs or alcohol for the six months before treatment and make themselves subject to drug testing throughout their treatment. The board voted against that restriction too.

The vote follows more than a year of advocacy from a coalition of organizations led by Vermont Legal Aid’s Office of the Health Care Advocate. The coalition includes the American Civil Liberties Union of Vermont, the Prisoners’ Rights Office and the Vermont People with AIDS Coalition.