Louisiana Hep C Agreement
Washington State has reached a similar agreement under Gov. Jay Inslees to eliminate hepatitis C by 2030, even though it has an unlimited five-year license with AbbVie with a scheduled launch date next week. Unlike a simple subscription model, which would require CMS approval, Washington has let drug manufacturers offer a price. The state will pay for this up to a certain level of total hepatitis C expenditure, and once that repository is reached, it will only spend pfennes per pill. Gov. John Bel Edwards said in a statement that the agreement made a day important not only for all concerned, but for the patients involved and their families previously without any reasonable treatment. Louisiana, the first state to announce a packaged hepatitis C drug, Asegua, a subsidiary of Gilead, will provide an unlimited amount of its Epclusa drug at a set price – about $58 million a year for five years or up to $290 million. Louisiana plans to treat about 31,000 medicaid patients and prisoners out of 39,000 who are believed to be suffering from the disease. The cost could fall to less than $10,000 per patient, depending on the contract provided by the National Public Health Office following a public request for a file. Under the “best price” Medicaid rule, manufacturers must offer the lower price of a drug they negotiate with any other buyer in all Medicaid states. However, additional rebates are exempt from this rule.
CMS approved the Louisiana program through a Medicaid State Plan Amendment, which authorized the state to negotiate its own complementary rebate agreements on the model. In their announcement, the Centers for Medicare and Medicaid Services encouraged Louisiana`s plan to seek approval from other countries to try subscription drug payment models for other expensive treatments. Such agreements can enhance state security over their Medicaid budgets, while ensuring that drug producers have a constant source of revenue. Because the state paid for DAA treatment per patient – at a total cost of nearly $60 million a year – the price to pay for treating all state residents with HCV, including prisoners, was estimated at $760 million. The state`s new contract with Asegua Therapies is based on a “subscription model” that allows Louisiana to pay a flat-rate annual fee of $58 million, based on its current AAD spending – for unlimited HCV treatment. During the five-year contract, government costs will be limited to $290 million. It is rare for government officials and businesses to celebrate a financial agreement. But in recent years, progress in the fight against hepatitis C has not been hampered by the lack of innovative medicines, but by a market that fails to make these drugs widely available. When revolutionary therapies were introduced in late 2013 to quickly cure chronic infection, manufacturers calculated prices of tens of thousands of dollars per treatment.
Many insurers have been willing to pay and have brought in tens of billions of dollars to pharmaceutical companies. www.wsj.com/articles/louisianas-deal-for-hepatitis-c-drugs-may-serve-as-model-11568347621 The payment model limits a six-month effort by the state to find and secure a pharmaceutical partner and pharmaceutical partner willing to provide a limited AAD treatment rate to patients in need in Louisiana. Asegua was initially announced as its selected partner in April, and its formally agreed plan aims to begin immediately. But that would be an improvement over the nearly $387 million spent by government officials since 2014 to treat only 10,377 people, according to state records. This works at an average price of $37,259 per piece, although actual fees vary depending on the program. “They have lost market share and price per share,” Bach said. “If payers (such as Medicaid programs) can give them the same income with much more security, they will prefer uncertainty about what`s happening now.”