Earlier this year, Florida attorneys filed two class-action lawsuits against UnitedHealthCare Services Inc. and Florida Blue after nearly 9,000 patients living with hepatitis C virus (HCV) were denied coverage for treatment. This week, the law firm that filed the suits successfully obtained settlements from both insurance companies in a deal valued at over $500 million, Law.com reports.
Filed by Miami-based firm Rivero Mestre, the cases specifically concerned Harvoni (sofosbuvir/ledipasvir), a next-generation hepatitis C drug that is up to 99 percent effective at curing the virus. However, the cures come with a steep price tag, costing up to $63,000 per patient for a standard course of treatment, which prompted insurers across the country to deny coverage and set various restrictions for access to the medication.
As a condition of the settlements, which were approved by a West Palm Beach federal judge, both insurers removed a requirement that policyholders must demonstrate abstinence from drug and alcohol use for at least six months before beginning treatment. The law firm estimates that the settlements secured HCV treatment insurance coverage for nearly 9,000 Floridians.
The news comes in the midst of several other lawsuits, settlements and legal decisions mandating that state Medicaid programs and insurers drop discriminatory restrictions on hep C treatment, from sobriety requirements to limits based on individuals’ degree of liver damage.
Currently, the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of American (IDSA) recommend hepatitis C treatment for nearly all HCV-positive patients, including those with early stages of the disease and a history of drug abuse and addiction. Ongoing attempts to limit access to the medications are both against sound medical guidelines and potentially against the law in the United States.