Medicare Spending On Hepatitis C Drugs Doubles To $9 Billion

By John Lavitt 11/19/15

Payments for the life-saving drug regimen have skyrocketed with no end in sight.

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Given the breakthrough medications now available for hepatitis C, Medicare spending will nearly double this year, passing the $9 billion mark. In light of the controversial high cost of the HCV drug regimens, insurance costs for all beneficiaries, whether or not they have the liver-wasting viral disease, are skyrocketing. The price of prescription drugs and insurance premiums are the public's top healthcare concern in recent opinion polls.

New cost estimates indicate that Medicare's popular prescription drug program will spend $9.2 billion on hepatitis C drugs in 2015. This is a 96% increase from $4.7 billion spent in 2014 and nearly 7% of drug costs for all of Medicare Part D. In 2016, the prescription program's standard deductible is going up by $40, to $360. It's by far the largest increase in the deductible since the inception of Part D 10 years ago. The Associated Press requested the numbers from Medicare's Office of the Chief Actuary, a division that handles economic analysis.

Hepatitis C affects anywhere from three to six million people in the United States, claiming more lives here than AIDS in the past year. More than three out of four infected adults are baby boomers, the age group, huge from a population standpoint, now entering Medicare. The cost could be staggering given the fact that the new drug regimens to cure the disease can cost from $80,000 to $100,000.

Primarily spread by contact with infected blood, hepatitis C is a virus that attacks the liver. With a long gestation period, hepatitis C can take years to produce symptomology. Once active, the virus feels like a bad flu that never goes away. While the disease advances gradually, it can ultimately destroy the liver, requiring a transplant to save the patient's life.

Medicare's economic analysts say hepatitis drugs have become one of the main cost drivers for the prescription program, but they also believe the cost is justified. "If you think about it, these are really drugs that can prevent liver disease," said Sean Cavanaugh, deputy director for Medicare with the Centers for Medicare and Medicaid Services. "We felt it was most appropriate to allow patients to have them earlier."

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Growing up in Manhattan as a stutterer, John Lavitt discovered that writing was the best way to express himself when the words would not come. After graduating with honors from Brown University, he lived on the Greek island of Patmos, studying with his mentor, the late American poet Robert Lax. As a writer, John’s published work includes three articles in Chicken Soup For The Soul volumes and poems in multiple poetry journals and compilations. Active in recovery, John has been the Treatment Professional News Editor for The Fix. Since 2015, he has published over 500 articles on the addiction and recovery news website. Today, he lives in Los Angeles, trying his best to be happy and creative. Find John on Facebook, Twitter, and LinkedIn.