Washington is the fourth state in the country to successfully negotiate a Netflix-style subscription deal for hepatitis C virus (HCV) treatment, joining Colorado, Michigan and Oklahoma in pursuing a model that will likely open up access to treatment for thousands of patients, Modern Healthcare reports

Approved by the Centers for Medicaid and Medicare Services (CMS) last week, the deal would enable Washington’s Medicaid program to pay a fixed annual amount for an unlimited supply of hepatitis C treatment for its beneficiaries. Washington’s is the first of these programs to focus primarily on hepatitis C products.

The goal is to help reduce state and federal spending on prescription drugs through deals that benefit both the agencies that pay for them and the pharmaceutical companies that make them. To help facilitate these deals, CMS has established a new rebate template for states that includes outcomes-based benchmarks, the intervention population for which benchmarks will be measured and an evaluation methodology to see how the programs are working. 

Washington authorities are focusing on hepatitis C spending because chronic HCV cases in the state rose by 60% from 2009 to 2017, while the number of acute cases across the state more than tripled. By paying a lump sum, the state could save millions of dollars while treating more patients than it has ever been able to before. 

However, some say these deals don’t directly address the real problem—namely, the high prices set by drugmakers, which are inflating state Medicaid budgets in the first place. Some also argue that the administrative cost of tracking these programs for efficacy could offset the potential savings over time.

To learn more about the push for subscription models to expand access to hepatitis C treatment, click here.