Louisiana Department of Health has signed an agreement with Asegua Therapetics, a subsidiary of Gilead Sciences Inc., for an unlimited supply of a generic version of Hepatitis C drug Epclusa.
The deal, which state officials announced Wednesday, will allow the state unlimited access to the drug at an annual cost not to exceed $58 million for five years. That’s the same estimated cost of treating just 1,141 patients over the past 12 months. The innovative payment model is aimed at lowering the overall cost of treating at-risk patients.
Under the new agreement, the state’s goal is to treat 31,000 of the 39,000 patients in Louisiana’s Medicaid program and prison system with Hepatitis C by the end of 2024, according to Dr. Rebekah Gee, secretary of the Louisiana Department of Health.
The deal for the drug, which cures up to 98% of Hepatitis C patients, has been three years in the making.
Louisiana is the first state in the nation to start plotting a subscription model like this one, dubbed the ‘Netflix model’ based on the unlimited-access, single-price approach, said Governer John Bel Edwards at a press conference.
“It is time that Louisiana lead,” Edwards said to applause from a room full of Louisianahealth care providers and policy makers. “And we are leading.”
The deal has been signed and approved by Centers for Medicare and Medicaid Services, which approved a similar deal for Washington state earlier this month.
“The high cost of prescription drugs is one of the greatest challenges in our healthcare system, and Louisiana’s innovative approach to leveraging a subscription model to promote access to Hepatitis C therapy is a great example of how states can lead in designing solutions,” said CMS Administrator Seema Verma in a statement.
The yearly value of the new plan will depend on when people with the disease are treated. If the state treats all 31,000 patients it has identified as its goal at a steady rate over five years, the cost to treat each person could work out to around $9,350. The medicine Asegua is providing is typically $24,000 per treatment. In order to break even, the state would have to treat just over 2,400 people per year.
But providers hope that the effects of such a program will ripple much farther than providing treatment for Hepatitis C, eradicating a disease that increases the risk of diabetes, heart disease, stroke, liver disease and liver cancer.
“Make no mistake, this is a Hepatitis C elimination strategy,” said Gov. Edwards.
Providing treatment to a vulnerable community is also a way to get people in the door for other treatments. Louisiana plans to link this program to other services like needle exchange programs, HIV testing and addiction services, said Alex Billioux, the assistant secretary of health for the Louisiana Health Department.
And importantly, access to a cure will remove shame associated with the disease and encourage people to get tested, officials said.
“No more stigma — for anyone,” said Gee.
Hepatitis C kills more people in the United States than all other infectious diseases combined, according to the health department. The new plan begins on July 15, though officials anticipate it may take more time to get the medicine into the hands of Hepatitis C patients. It does not cover everyone with Hepatitis C without private insurance, like people on disability who chose a Medicare plan without part D.
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