R.I. Medicaid limits supply of Hepatitis C drug due to cost

Rhode Island’s Medicaid program decided in September to ration the delivery of Sovaldi, a prescription drug approved by the U.S. Food and Drug Administration last year to cure chronic Hepatitis C, due to the drug’s high cost and the relatively high prevalence of the virus among Medicaid enrollees in the state.

The state’s Medicaid policy stipulates that payment for treatment be approved only for patients with late-stage liver failure, as opposed to younger Hepatitis C patients who became infected as a result of drug use amidst the opioid addiction crisis in southern New England. Patients looking to have the treatment covered by Medicaid must be substance abuse-free for at least six months or actively involved in rehabilitation.

Hepatitis C is the “poster child for health disparities,” but treating all those infected by the virus would bankrupt the state, said Lynn Taylor, assistant professor of medicine, director of Miriam Hospital’s HIV/Viral Hepatitis Coinfection Program and the recipient of a grant from the Rhode Island Foundation to develop a strategic plan to address Hepatitis C.

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