It will soon be easier for Medicaid beneficiaries in Massachusetts to get hepatitis C medications thanks to a new drug rebate program.
MassHealth, the state's Medicaid program, said Thursday that it has negotiated with Gilead Sciences to receive new, lower rebates for the drugmaker's hepatitis C drugs. In exchange, Gilead's drug Harvoni will be the exclusive therapy for approximately 80% of MassHealth members with hepatitis C.
“Our goal is to ensure a sustainable, cost-effective approach to covering MassHealth members who need treatment for hepatitis C infection,” said Secretary of the Executive Office of Health and Human Services Marylou Sudders. “We will continue to push drug companies to give us the very best prices on new treatments as they come on the market.”
In addition, MassHealth also secured rebates for Gilead's Sovaldi and Bristol-Meyers Squibb's therapy Daklinza. The list price for Harvoni is $94,500 for a 12-week treatment course, whereas Sovaldi runs $84,000 for its 12-week run. Daklinza is the most affordable of the three, with a list price of $63,000 for 12 weeks.
The new drug rebate program will go into effect Aug. 1, MassHealth said.
According to the CMS, Delaware and Florida also recently unveiled efforts to widen access to hepatitis C drugs. But Andy Slavitt, the CMS' acting administrator, said manufacturers and others need to make more of an effort to make these drugs more affordable.
“While we are encouraged that competition in the marketplace has resulted in significant reductions in price over the past year, the CMS remains concerned that the cost of hepatitis C medications remains high, placing a significant financial burden on states,” He said. “We call on manufacturers and pharmacy benefit managers to continue to find innovative ways to make them more affordable to state Medicaid programs and the beneficiaries they serve.”
MassHealth says it covered hepatitis C drugs for approximately 2,830 members between December 2013 and January 2016, which cost the plan $318 million. That cost doesn't include other hepatitis C-related treatment services such as outpatient treatment, which may have also been paid for by MassHealth or its managed-care organizations.
On Tuesday, the Food and Drug Administration approved Gilead's new hepatitis C drug, Epclusa, which combines Sovaldi with another drug and is the first pill approved to treat all major forms of the virus. Epclusa runs $74,760 for 12 weeks.