Health officials in Missouri have officially reversed course on the state’s restrictive hepatitis C virus (HCV) treatment policies, announcing that moving forward, any Medicaid enrollee who tests positive for the virus will be able to access next-generation medications to cure the disease, Tribune News Service reports.
The policy change is a direct result of a lawsuit filed last year by attorneys with the National Health Law Program, Legal Services of Eastern Missouri and the St. Louis University Legal Clinic, which sued Missouri’s Medicaid program over allegations that HCV-positive patients were being denied medically necessary treatment across the state.
The case was filed in federal court in Missouri’s western district on behalf of three unnamed people living with hepatitis C. The lawsuit has since been dismissed following the state’s decision to change its policy earlier this month.
Until now, Missouri’s Medicaid program allowed only its sickest patients to access next-generation hepatitis C treatments, a cost-saving measure mirrored by many other state health care programs across the country. Health officials in Missouri initially argued that HCV treatment was costing the state up to $93,000 per patient for a standard 12-week course of treatment, a high price for care considering that an estimated 13,000 Missourians are currently living with hepatitis C.
In the lawsuit, plaintiffs not only alleged that the state was breaking federal law by restricting HCV treatment access, but also that Missouri could save money in the long run by opening up access to the lifesaving medications. Since then, the state has announced that the price of hepatitis C drugs has declined, enabling health officials to consider more widespread access.
Missouri’s decision to roll back its Medicaid restrictions on hep C treatment follows a national trend. In 2014, a report by the National Viral Hepatitis Roundtable (NVHR) and the Center for Health Law and Policy Innovation at Harvard found that 91 percent of states were limiting patient access to next-generation HCV medications based on individuals’ degree of liver damage, or fibrosis score. In 2017, that number has dwindled to 23 percent.