HCV drug costs to exceed $55 billion in state funds

State budgets will be stretched thin in order to afford expensive new hepatitis C virus drugs for patients who will be treated through public programs, according to a report from Express Scripts.

The state-by-state analysis projects that state governments collectively will spend more than $55.2 billion if they provide sofosbuvir (Sovaldi, Gilead Sciences) and ribavirin treatment to the more than 750,000 chronic HCV patients on Medicaid or in prison, even with the 23% discount drug manufacturers are mandated to provide to Medicaid.

“There is no doubt that Sovaldi is a breakthrough therapy, but unfortunately, it is also likely to break state budgets,” Steve Miller, MD, Express Scripts’ chief medical officer, said in a press release. “Since health care for so many HCV patients is funded by state programs, each citizen will be shouldering the unprecedented cost burden. The unsustainable pricing of this medication has essentially become a tax on all Americans.”

Steve Miller

An earlier report estimated an 1,800% national increase in public spending on HCV drugs in 2016 compared with 2013 — an unprecedented spending increase among major classes of drug therapies, according to the release. California alone is expected to spend $6.6 billion for 93,000 eligible HCV patients, and is followed by Texas, Florida, New York and Illinois as states with the greatest estimated total costs.

“HCV treatment costs are expanding at a rate that is simply not sustainable for the Medicaid program,” Jeff Myers, president and CEO of Medicaid Health Plans of America, said in the press release. “The current treatments, along with the all-oral medication coming in October, threaten to drive the price to a point at which the states unfortunately will be forced to make tradeoffs to manage the very large population that is infected with this life-threatening disease.”