[Bloomberg BNA] How Will Medicaid Plans Cover Specialty Drugs?

According to a recent survey from the Kaiser Family Foundation, almost every state Medicaid plan is concerned about the rising cost of specialty drugs — specifically Sovaldi. Sovaldi is a hepatitis c drug from Gilead Sciences which costs  $1,000 a pill, or $84,000 for a 12-week treatment—prices which the plans have balked at. But the drug has a cure rate up to 92 percent. In early October, Gilead received FDA approval on its next-generation hepatitis C drug, Harvoni. That drug delivers cure rates of 94 to 99 percent, but comes with a similarly high price tag of $31,500 a month. Plans have said the costs will break the bank; but at the same time, they can’t deny beneficiaries access to a drug that will cure the disease.

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