After pricey new hepatitis C treatments emerged a few years ago, public and private payers restricted coverage in order to ease the financial strain on budgets. But even as more competition among drug makers has prompted discounting, payers continue to deny coverage, including to patients who suffer from the most advanced forms of the disease, according to a new analysis.
As of last September, 37 percent of patients with little to moderate trace of the disease were denied coverage, a mostly steady increase from 27 percent in October 2015. Meanwhile, 24 percent of those severe forms of hepatitis C were denied, up from 15 percent during the same time period. These figures represent an overall trend that includes commercial and government payers.
“This concept of rationing health care is simply not following the path that was initially proposed by payers, which was to make the medicines available to patients who are suffering the most,” said Dr. Nezam Afdhal, a co-author of the analysis, who is chief of hepatology and director of the Liver Center at Beth Israel Deaconess Medical Center in Boston. “It’s really kind of staggering.”
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