Louisiana has picked a pharmaceutical company for its unusual plan to broaden access to hepatitis C drugs for Medicaid patients and prisoners through a Netflix-style subscription model, the state health department announced Tuesday.
Gilead Sciences subsidiary Asegua Therapeutics won the contract, selected from three companies that sought to partner with the state. Louisiana will pay a fee to the drug manufacturer for unlimited access to its hepatitis C medication, a generic version of Epclusa, for five years.
During that period, Louisiana will treat as many Medicaid patients and prisoners as it can, rather than pay a per-patient treatment price that is so costly it has severely limited access.
The state's health secretary Rebekah Gee said Louisiana will have the first subscription model for hepatitis C treatment in the U.S. Other states struggling with prohibitively expensive costs for the drugs are watching the concept.
The plan submitted by Asegua offers "a clear path forward to offer a hepatitis C cure to our most vulnerable patients," Gee said in a statement. She expects the contract, still under negotiation, to begin July 1.
The Centers for Disease Control and Prevention says hepatitis C, a blood-borne viral infection that can cause liver failure and death, kills more Americans than any other infectious disease. But the cost of treatment is high. Gee has said a course of the medication costs about $20,000 to $30,000.
Louisiana has an estimated 39,000 people with hepatitis C on Medicaid or in prison, relying on the state for care. The health department said fewer than 3% of those on Medicaid and only a handful of people in prison were treated last year, because the state restricts who receives medication to the most severe cases.
To treat and effectively cure everyone in the state's care with hepatitis C under the traditional per-patient price would carry a cost around $760 million, according to estimates released by the health department.
Instead, Louisiana spends about $35 million on hepatitis C treatment annually.
Drug companies that sought the contract had to offer proposals with unlimited access to hepatitis C treatment for five years, without costing the state any more annually than the current spending level.
Gregg Alton, an Asegua representative, called the subscription model "groundbreaking."
"This is an important step forward on the path to eliminating the virus in Louisiana," he said in a statement.
The health department said its goal is to treat more than 10,000 Medicaid patients and prisoners by the end of 2020—about one-quarter of the population in the state-financed programs with the virus.
Corrections Secretary Jimmy LeBlanc said treating prisoners will improve public safety.
"By curing these offenders, we are releasing healthier individuals to the communities, and we are protecting the public by further preventing the spread of the hepatitis C epidemic into Louisiana's towns and cities," he said.
