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Louisiana One Step Closer to Breakthrough Approach in Hepatitis C Treatment

Innovative subscription payment model will make medication available to state’s most vulnerable populations

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A new agreement between the state of Louisiana and a drug maker is paving the way for an innovative subscription payment model that would enable the agency to treat their most vulnerable hepatitis C populations.

With financial support from Arnold Ventures, the Louisiana Department of Health was able to design the bold payment model in 2018 and launch a robust public health strategy to ensure access to lifesaving hepatitis C medications for as many people as possible. A number of grant recipients were crucial in the successful implementation of the model, including Dr. Peter Bach of Memorial Sloan Kettering’s Drug Pricing Lab, Dr. Joshua Sharfstein of John Hopkins Bloomberg School of Public Health, and Dr. Rena Conti of Boston University Institute for Health System Innovation & Policy.

“Nearly 2.4 million Americans live with hepatitis C, more than double those living with HIV, and while an effective cure exists, it comes at a very high price,” said John Arnold, founder and co-chair of Arnold Ventures. “We were pleased to support Dr. Rebekah Gee with the Department of Health in her work to eradicate the hepatitis C virus from Louisiana at no additional financial cost to the state.”

The deal will make a generic treatment available to the state’s Medicaid and incarcerated population, with the state paying the drug maker a fixed amount for unrestricted access over the next five years. With this latest move, Louisiana takes another step toward becoming the first state in the nation to establish such a model — paving the way for other states to expand access to hepatitis C treatment at a lower cost per treatment and potentially serving as a new payment model for other drugs.

On Tuesday, Dr. Rebekah Gee, Secretary of the Louisiana Department of Health, announced the agency has chosen Asegua Therapeutics, a subsidiary of Gilead, to make their authorized generic Epclusa available to the state’s Medicaid and incarcerated population.

“We were extremely pleased that three manufacturers offered proposals, with the plan submitted by Asegua offering us a clear path forward to offer a hepatitis C cure to our most vulnerable patients,” Gee said in a news release issued by the agency.

The goal, according to Gee, is to treat more than 10,000 individuals by the end of 2020. (Less than 3 percent of Medicaid patients in Louisiana who have hepatitis C were treated in 2018, according to the Louisiana Department of Health).

Millions of Americans living with hepatitis C breathed a sigh of relief when a breakthrough cure first debuted in 2013. That is, until they realized the price tag: $84,000 per treatment. While the price has fallen in recent years, it remains too high for widespread access. And the cost of treating those on Medicaid or who are incarcerated or uninsured falls largely on state governments, which often face tight budgetary constraints.

The agreement between the Louisiana Department of Public Health and the drug maker is expected to be finalized by June 1, with the official implementation of the model anticipated on July 1.