After months of considering the implementation of a “Netflix-style” subscription model for hepatitis C virus (HCV) treatment, Louisiana has selected a subsidiary of Gilead Sciences, Asegua Therapeutics, as its partner for the unusual plan, Modern Healthcare reports. 

Asegua beat out three other companies to win the contract to provide direct-acting antivirals to all of Louisiana’s Medicaid patients and prisoners. Under the first-of-its-kind treatment model, rather than pay a per-patient treatment price, Louisiana will pay a flat fee to the drug manufacturer for unlimited access to one of its hepatitis C cures: sofosbuvir/velpatasvir (a generic version of Epclusa) over five years. During that period, the state will treat as many people as it can.

Louisiana has an estimated 39,000 people living with hepatitis C enrolled in its Medicaid program or incarcerated under the state’s Department of Corrections (DOC). Thus far, Medicaid and the DOC have significantly restricted access to hepatitis C medications, treating less than 3 percent of those on Medicaid and only a small number of inmates. As have many other states, Louisiana has long cited the high cost of hepatitis C treatment as the cause, estimating that paying for each individual’s treatment would cost around $760 million.

Though the amount of the deal has not been disclosed and is still being negotiated, Louisiana’s health department says its goal is to treat more than 10,000 Medicaid patients and prisoners by the end of 2020—about 25 percent of the state’s HCV-positive population. The contract is slated to begin July 1, 2019.

Meanwhile, state Medicaid and prison systems across the country will be monitoring Louisiana’s subscription-model program to gauge its success.