Doctors are finding themselves in tense situations as they try to
prescribe new hepatitis C drugs to patients eager for a cure while
health plans limit coverage to manage the costs of the medications.
health insurers have established prior-authorization criteria generally
limiting access to the drugs to patients whose disease has progressed
to at least Stage 3 fibrosis (just before the onset of liver cirrhosis).
The sticker prices of a course of treatment of the drugs range
as high as $95,000. To mitigate the burden, major health insurers and
pharmacy benefit management companies have entered special pricing
agreements with Gilead for its new hepatitis C drugs Harvoni and Sovaldi or AbbVie for its competing drug Viekira Pak.
Labels: access to new drugs, co-pays, collaborations, cost of treatment, insurance coverage