The Effects Of Hepatitis C Virus On Health Care And...

Medical insurers exist in the uncomfortable realm of providing support for health care and ensuring healthy profit margins. The payor system has evolved to dictate the care its members receive through, at worst, a rationing of services. This has frequently been the case when new medication and experimental treatments become available. The most recent instance is the case of newly released drugs with astounding success rates for the cure of Hepatitis C Virus. The rulings of past civil cases requiring insurers to cover medical treatment despite contract clauses has set the stage for Hepatitis C Virus curative treatment. Hepatitis C Virus and Treatment Hepatitis C Virus (HCV) was officially discovered in 1989 at the National Institutes of†¦show more content†¦Initial curative treatment in the early 1990’s used interferon and the antiviral ribavirin with a cure rate of 50% (Watson, n.d., p. 1). 2011 saw the invention of two antiviral medications, telaprivir and boceprevir, that increased cure rates to 70%. In 2013 newer drugs, simeprevir and sofosbuvir, were introduced with the later creating 90% cure rates in patients (Watson, n.d., p.gs. 1-2). Simeprevir (Sovaldi) was created for administration once per day over a minimum of a year (Gilead, 2014). Eradication of the disease in patients is effective in patients co-infected with HIV with low rates of side effects (Sulkowski, et al., 2014), highlighting its efficacy in complex patient populations. The cost of such treatment is $1,000 per day with an average cost for curative course exceeding $94,000 (Venteicher, 2014). The medication is FDA approved and prescribed re adily, but patients are not receiving access to the medication through their insurers. Current Issues of Access Patients with HCV treatment including Sovaldi are experiencing life changing medical prognosis in a disease that had low cure rates. Physicians are prescribing the medication appropriately to patients but there exists a disconnect between the number of patients accessing the drug and the number it is medically indicated for (Venteicher, 2014). Insurers and Managed Care Organizations (MCO’s) administering Medicaid contracts for multiple states across the United States are denying access to the