CHLPI Study on HCV Health Insurance Restrictions Published in Annals of Internal Medicine

On June 30, 2015, the Center for Health Law and Policy Innovation, along with researchers from Brown University Department of Medicine, Rhode Island’s Miriam Hospital, Treatment Action Group, and Kirby Institute of Australia, was highlighted in an article published by the Annals of Internal Medicine. The study examined reimbursement criteria for sofosbuvir (Sovaldi), a highly effective medication to cure Hepatitis C in the overwhelming majority of patients. The article details the coverage restrictions put in place by most Medicaid programs, and calls for policy change to improve access to new life-saving HCV treatment.

“Ultimately, we found that access restrictions are not based on scientific evidence, current treatment guidelines or clinical data,” said co-author and CHLPI Director Robert Greenwald. Greenwald adds, “Notably, 74% of the 42 state Medicaid programs for which information is available limit treatment to individuals with advanced fibrosis or cirrhosis.” Based on its findings the study recommends that states review their access criteria and revise them as needed to align with national clinical recommendations.

Read the article in the Annals of Internal Medicine.
Access a downloadable PDF of the article with methods, results, and discussions.
Read the press release from the Center of Health Law and Policy Innovation.

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