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Colorado to expand coverage for Hep C patients, but some still won't get the expensive drug

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Posted at 4:57 PM, Sep 01, 2016
and last updated 2016-09-01 18:57:17-04

DENVER -- Colorado will increase access to a life-saving, expensive hepatitis C drug, covering needy patients in earlier stages of liver disease than were previously considered, the state Medicaid department said Thursday.

The decision comes after criticism from the ACLU Colorado and Denver Health Medical Center and a recommendation from the state drug review board, which provides guidance on drug coverage for the state insurance program for needy Coloradans.

The state has paid for the 12-week drug treatment with a 90 percent cure rate only for patients who were in the final two stages of liver disease. Under the new policy, Medicaid patients can receive the drug if their liver damage has advanced to the second out of five stages — zero meaning no liver damage and four diagnosed as cirrhosis.

The policy also expands coverage to women who plan to become pregnant within the next year, regardless of the stage of their liver scarring. And it loosens a previous restriction barring anyone who used alcohol or illegal drugs within the last six months. Now people with a history of chronic substance abuse will have to enroll in drug treatment counseling at least one month before receiving the hepatitis C regime.

Critics of the old policy pointed to the fact that most new cases of hepatitis C are people who are substance abusers and share needles. Treating people who are spreading the virus through needles is the “most important way to stop the spread and slow this epidemic around the country,” said Dr. Sarah Rowan, associate director of HIV and viral hepatitis prevention at Denver Public Health. 

Read the rest from our partners at the Denver Post

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