Drug costs a bitter pill

TALLAHASSEE

An estimated 17 percent of America’s prison population could have hepatitis C, a severe viral disease that can lead to cirrhosis, liver failure and cancer if left untreated.

There is a cure. A miracle drug with a 95 percent recovery rate was introduced in 2013. But Sovaldi has an extremely high cost: $84,000 for a standard treatment, although costs can vary with the length of the treatment.

Late last year, Gilead Sciences, which makes Sovaldi, won approval for an even better hepatitis C drug, which doesn’t have to be taken in combination with other drugs that have major side effects. But Harvoni costs about $1,125 per pill, with a standard 12-week treatment priced at $94,500

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As Minnesota insurers limit access to hepatitis C drugs, patients chafe

Kelly Krodel thought a miracle had arrived just in time — in a drug that could eliminate the hepatitis C infection she had carried for three decades before it started to wreck her liver.

Turns out, she’s going to have to live with the virus a bit longer. As long as the South St. Paul woman is reasonably healthy, her health insurance won’t pay the drug’s five- or even six-figure cost.

“Now there’s a cure and I can’t even touch it,” she said. “It makes you so angry.”

Krodel is one of a growing number of hepatitis C patients in Minnesota caught in a bind between the exorbitant cost of the year-old medications — Harvoni, Sovaldi and Viekira Pak — and the tight restrictions insurers have used to prevent the drugs from busting their budgets.

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USA-Lack of Insurance Bars Some from Hepatitis C Treatment

Survey data from 2001 to 2010 show that lack of insurance kept some people with hepatitis C virus from getting treatment.

Recently, more effective and well-tolerated drugs have been developed to treat hepatitis C, removing many of the discouraging side effects of older drugs. The infection is curable and transmission can be prevented, researchers write in the American Journal of Gastroenterology.

But for the more than three million people in the U.S. who have chronic liver disease from hepatitis C, there are still two important barriers to getting treatment, said lead author Dr. Ivo Ditah from the Mayo Clinic in Rochester, Minnesota.

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Hepatitis C drug a costly but promising cure

Sallie Wickens’ life followed a death-defying narrative that traced the medical arc of hepatitis C:

A blood-transfusion infection after a car accident in 1959, when she was 5; a positive test for the virus when she was 30; 10 years of deteriorating health; debilitating interferon drug treatments that didn’t work; a liver so damaged she needed a transplant.

And then, her doctor, hepatologist Laura Alba, walked into an exam room last month at St. Luke’s Hospital and gave Wickens, 60, a big smile.

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$1,000 Hepatitis C drug in spotlight at healthcare hearing

A $1,000-drug used to treat Hepatitis C was a hot-button topic at a California Senate committee hearing Wednesday.

"We are really concerned about the high cost of specialty drugs, which have just continued to increase year after year and are going to end up taking 50 percent of the budget of all of the pharmaceutical costs," Pharmacy and Adult and Family Medicine Executive Director at Kaiser Permanente Dr. Sameer Awsare said.

But drug prices were just one part of the bigger problem of rising healthcare costs. Speakers said that physician fees and hospital facility fees are also a major factor. The growing bill means that consumers, including people with employer-sponsored insurance, are being asked to shoulder more costs out of pocket. In fact, the Health Care Costs Institute released a new report this week finding that people with insurance through work paid 15 percent of their medical expenses out of pocket in 2013, up 6.9 percent year-over-year.

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The White House signals a fight on high drug prices

On Monday, the Obama administration proposed taking a major step towards bringing prices down for expensive specialty medications.

In its budget, the White House calls for Medicare's prescription drug program to negotiate on prices for "high-cost drugs" and biologics, a complex and expensive class of drugs that is just starting to get competition from generics in the United States. "The administration is is deeply concerned with the rapidly growing prices of specialty and brand name drugs," the budget reads.

The Department of Veterans Affairs and state Medicaid programs get mandated discounts on these drugs, but Medicare was forbidden by the 2003 law creating its prescription drug program to negotiate on price. For years, liberals have been pushing to give Medicare that authority, which would make the United States more like the rest of the world.

It's not clear how hard the administration will fight for this idea, but you can add this to the list of budget requests that probably aren't going anywhere. Drug companies and Republican lawmakers have regularly pushed back against the idea of price controls in Medicare Part D.

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Germany: German insurers win discounts on Gilead's Sovaldi

Jan 24 (Reuters) - U.S. biotechnology company Gilead has conceded its first discounts in Germany on its key hepatitis C drugs Sovaldi and Harvoni, German business weekly WirtschaftsWoche reported.

The head of Gilead's German operations told the magazine that discounts from the list price of 60,000 euros ($67,242) per treatment had been negotiated with four of Germany's statutory health insurers but declined to give the size of the discounts.

"Thirty-five percent of people with statutory health insurance are already profiting from the discount agreements," Carsten Nowotsch said in an interview to be published on Monday, adding that more such contracts could follow.

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Australia: The miracle cure with a billion-dollar price tag

It's been hailed as a miracle cure for hepatitis C – but comes with a billion-dollar price tag.

The Commonwealth government is under pressure to subsidise Sovaldi, produced by drug company Gilead, that has been approved by the Therapeutic Goods Administration but has been rejected for listing on the Pharmaceutical Benefits Scheme on value-for-money grounds.

The Pharmaceutical Benefits Advisory Committee, the independent expert body that decides which drugs should be subsidised, will consider a second application to list the drug at its March meeting, along with applications to list three other new hepatitis treatments.

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New drugs offer hope, barriers for hepatitis C patients

For patients with hepatitis C, the last year has brought great hope: New drugs that are highly effective with few side effects. But their high cost has led Medicaid officials in Pennsylvania and other states to put up barriers for patients, treating only the sickest ones and leaving many others to wait.

"This is an unprecedented approach we've had to take with these drugs," said Terri Cathers, pharmacy director for Pennsylvania's Office of Medical Assistance Programs. "We've not done this before for other treatments as long as I've been in the business."

The approach, she said, is a direct result of the cost, which can range up to $150,000 per patient.

Read more at http://www.philly.com/philly/health/20150104_New_drugs_offer_hope__barriers_for_hepatitis_C_patients.html#HAz2fKXJskLoLyFP.99