The Centers for Disease Control and Prevention estimates that 15,000 Americans die each year from hepatitis C – similar to the numbers that die from AIDS.
Many people with the disease don’t know they are infected, as the disease can lay dormant for years, even decades. But severe cases can lead to liver cancer and cirrhosis.
But a new, potentially life-saving drug was approved by the Food and Drug Administration in December, and it brought fresh hopes of a cure for the estimated 3.2 million Americans with chronic hepatitis C.
Then came the sticker shock. The price tag of Sovaldi is $84,000 per treatment – or $1,000 a pill.
Faced with a $7.2 million bill after a short time of paying for the drug, Colorado’s Medicaid program put the brakes on covering Sovaldi early this year. Between late January and May, only four of the 43 Medicaid patients who applied to receive the drug received it.
The state Medicaid program will now take into account a list of factors when deciding which patients can receive the treatment, according to interim criteria that went into effect June 1. Among those excluded will be people who have already undergone treatment for the most common genotype of the disease in the United States, and some with a rarer form of the disease believed to be less responsive to Sovaldi.
Meanwhile, the new drug's manufacturer, Gilead Sciences Inc., has come under pressure from U.S. legislators. Representative Diana DeGette, a Democrat from Colorado, was among members of Congress who sent a letter to the pharmaceutical company in March demanding to know how Gilead reached its price tag for Sovaldi.
“Our concern is that a treatment cannot cure patients if they cannot afford it,” the legislators wrote.
Gilead spokeswoman Cara Miller told Rocky Mountain PBS I-News that Sovaldi was priced to match the cost of prior regimens, and reduces the total cost of hepatitis C treatment when taking into account doctors’ visits and the costs of treating side effects.
But the bottom line at this point is that the pricing has put the drug out of reach for many Coloradans suffering from the disease, which has a bigger footprint in lower-income populations.