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Medicare Spent $4.5B on New Hepatitis C Drugs in 2014

Posted on March 30, 2015

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(HealthNewsDigest.com) – Medicare spent $4.5 billion last year on new, pricey medications that cure the liver disease hepatitis C, ProPublica’s Charles Ornstein reports today — more than 15 times what it spent the year before on older treatments for the disease, according to previously undisclosed federal data.

The extraordinary outlays for these breakthrough drugs, which can cost $1,000 a day or more, will be borne largely by federal taxpayers, who pay for most of Medicare’s prescription drug program. But the expenditures will also mean higher deductibles and maximum out-of-pocket costs for many of the program’s 39 million seniors and disabled enrollees, experts and federal officials said. <script type=”text/javascript” src=”http://pixel.propublica.org/pixel.js” async=”true”></script>

Highlights from Ornstein’s article, co-published with The Washington Post:

  • Medicare’s costs for the drugs, at least in 2014, appear to be far higher than those incurred by state Medicaid programs for the poor, which collectively spent $1.2 billion on the drugs in the first nine months of the year.
  • Many Medicaid programs, as well as private insurance companies, took a more restrictive approach toward the drugs than Medicare did, often requiring that patients have advanced liver disease to be eligible to receive the pills.
  • Dr. Bruce Bacon, a liver specialist at St. Louis University, will likely be ranked No. 1 for drug spending in Part D in 2014, federal data shows. He wrote 925 prescriptions for hepatitis C medications, costing $22 million. By contrast, the program’s top prescriber in 2012 wrote 76,000 prescriptions that cost $10.5 million.

The full story is here: http://www.propublica.org/article/cost-of-a-cure-medicare-spent-4.5-billion-on-hepatitis-c-drugs-last-year/; it is free to link to or republish under our Creative Commons License, and Ornstein, based in New York, is available for interviews.

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