Covered California Votes To Cap What Patients Pay For Pricey Drugs

"Starting in 2016, most people will only have to pay a maximum of $150 or $250 per prescription, per month. These caps are for Covered California's so-called silver and platinum plans. Bronze plans will have caps of $500."

In recent years, expensive specialty medicines used to treat cancer and chronic illnesses have forced some very ill Americans to choose between getting proper treatment and paying their rent.

To ease the financial burden, the California agency that governs the state's Obamacare plans issued landmark rules Thursday that will put a lid on the amount anyone enrolled in one of those plans can be charged each month for high-end medicine.

The agency says its rules, set to take effect in 2016, "strike a balance between ensuring Covered California consumers can afford the medication they need to treat chronic and life-threatening conditions while keeping premiums affordable for all."

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Canada: Personal-care worker struggles after contracting hepatitis C from client

The journey from the good life to bad started in the summer of 2011. Then, nearly 20 years into a career as a personal-care worker, Rowe took a client into her home for weekend care.

The non-communicative client cut herself in the bathroom and while a visiting nurse friend stemmed the bleeding, Rowe began to clean up.

“It’s summer, I’m in flip-flops and I’ve got cracked feet. I’ve got my gloves on, but they aren’t going to do anything for me.”

The client had hepatitis C and an unknowing Rowe contracted the disease.

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UK: NHS England accused of interference over hepatitis C drug

Officials at NHS England have been accused of interfering in a process to decide whether a drug which can cure Hepatitis C should be made available to patients on the health service.

Harvoni, which is a combination of two new generation hepatitis C drugs, is currently being appraised by the National Institute for Health and Care Excellence.

But at a meeting at NICE on April 1, it is claimed that two senior NHS England officials reminded those attending that they had to take into account the cost to the health service when deciding whether to approve any treatment.

This is, in fact, not true. NICE does not focus on affordability but rather on cost-effectiveness.

- See more at: http://blogs.channel4.com/victoria-macdonald-on-health-and-social-care/nhs-england-accused-interfering-approval-hep-drug/3011#sthash.rkyi6yYa.dpuf

6 Things People With Hepatitis C Wish You Knew

You might know someone living with hepatitis C and not even realize it. 

Having a chronic hepatitis C infection can affect a person’s day-to-day life more than you may expect. Hepatitis C is the most common blood-borne virus in the United States, with more than 3 million people infected, according to the Centers for Disease Control and Prevention (CDC). But even with such high numbers, patients feel there’s a lot of misinformation about this infectious disease.

Here’s what people diagnosed with hepatitis C want you to know about their illness:

1. Hepatitis C is a serious disease. “You can’t put your head in the ground,” says Joe Benko, 64, an Army veteran from Allentown, Pennsylvania, who learned he had the virus while donating blood. “If you have hepatitis C, you have to be proactive and approach it. That’s the only way to get rid of it."

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As insurers limit access to hep C drugs, patients and doctors bristle

Doctors are finding themselves in tense situations as they try to prescribe new hepatitis C drugs to patients eager for a cure while health plans limit coverage to manage the costs of the medications.

Many health insurers have established prior-authorization criteria generally limiting access to the drugs to patients whose disease has progressed to at least Stage 3 fibrosis (just before the onset of liver cirrhosis).

The sticker prices of a course of treatment of the drugs range as high as $95,000. To mitigate the burden, major health insurers and pharmacy benefit management companies have entered special pricing agreements with Gilead for its new hepatitis C drugs Harvoni and Sovaldi or AbbVie for its competing drug Viekira Pak.

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Will the J&J Deal With Achillion Transform the Hep C Market?

As drug makers jockey for their share of the fast-growing hepatitis C market, the deal between Johnson & Johnson JNJ -0.35% and Achillion Pharmaceuticals ACHN -15.26% has Wall Street analysts rethinking forecasts.

The deal, which was announced late yesterday after a Twitter rumor had Gilead Sciences GILD -0.35% buying Achillion, calls for J&J to invest $225 million and assume responsibility for development costs. Ultimately, the value of the agreement could reach $1.1 billion, depending on milestones reached.

For J&J, the move may help reposition the company as a player in the hepatitis C market. And for Achillion, the collaboration provides a deep-pocketed partner for a company that some saw as a buyout target. But to what extent will this transform the hepatitis C market and what are the implications for the other drug makers? Here are what some of the wags are saying…

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High Cost of Sovaldi Hepatitis C Drug Prompts a Call to Void Its Patents

Activists in several countries are seeking to void patents on the blockbuster hepatitis C drug Sovaldi, saying that the price being sought by the manufacturer, Gilead Sciences, was prohibitive.

The Initiative for Medicines, Access and Knowledge, a legal group in New York, is expected to announce Wednesday that it has filed challenges in Argentina, Brazil, China, Russia and Ukraine. In all those countries except China, the organization is being joined by local patient advocacy groups.

The actions are a sign that the controversy over Sovaldi is spreading beyond the United States, where the $84,000 charge for a course of treatment has strained Medicaid budgets, to middle-income countries.

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