The emergence of exceptionally high-cost drugs that offer unprecedented benefits for Hepatitis C patients has posed a considerable challenge to state Medicaid programs: the drugs offer cures, not treatment, yet their costs are potentially budget-busting.
The Medicaid and CHIP Payment and Access Commission commissioned a study to evaluate how these new drugs and their cost have affected state Medicaid programs and the managed care organizations that serve most Medicaid beneficiaries. Among the issues the study considered were:
- state coverage and prior authorization policies
- the impact of the new drugs on state Medicaid budgets and Medicaid managed care organizations
- how these experiences have influenced policy-makers’ approach to other high-cost drugs
For the answers to these questions and more, go here for the MACPAC report High-Cost HCV Drugs in Medicaid: Final Report.