State settles case over Medicaid coverage of hepatitis drugs

November 25, 2016

YAKIMA, Wash. (AP) — The agency that administers Medicaid in Washington state has reached a tentative settlement of a class-action lawsuit that sought broader coverage of expensive hepatitis C drugs.

The Yakima Herald-Republic reports (https://goo.gl/CzH55N ) that the Washington Health Care Authority has agreed to provide the medicine to all hepatitis C patients, not just the sickest ones.

Previously, the state based coverage of the drugs on a “fibrosis” score that measures scarring on the liver, and it would only provide the drugs to patients with advanced liver disease.

The drugs can cure the disease in more than 90 percent of patients, but they can cost about $95,000 for a 12-week course.

The lawsuit alleged that 900 people had been denied access to the drugs based on their fibrosis score.

In May, Seattle U.S. District Judge John C. Coughenour barred the state from continuing to deny the drugs. He ruled that the agency’s policy was not consistent with requirements that drugs be dispensed based on medical need.

The judge has yet to approve the settlement.


Information from: Yakima Herald-Republic, http://www.yakimaherald.com

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