Eliminating hepatitis C
The Health Care Authority (HCA) is partnering with the Department of Health (DOH) to work towards eliminating Hepatitis C in Washington State.
Hepatitis C virus (HCV) is the most common blood borne disease in the United States. Between 75 and 85 percent of people infected with HCV develop chronic HCV.
Chronic HCV is a lifelong virus that can cause severe scarring (cirrhosis) of the liver, liver cancer, the need for a liver transplant, and even death. The death toll from HCV continues to rise, tied to the opioid epidemic and the rise in drug injection.
About 65,000 Washingtonians live with chronic HCV. Approximately 25,000 are covered by state-purchased health care insurance, including:
- Washington Apple Health (Medicaid)
- The Public Employees Benefits Board (PEBB) Program
- The Department of Corrections (DOC)
- The Department of Labor & Industries (L&I)
Yes. In the past few years, medications have become available that cure HCV.
Numerous national organizations have noted that HCV can be eliminated in the United States in the future. Elimination is a state where HCV is no longer a public health threat, and where those few who become infected quickly learn their status and receive curative treatment, preventing the forward spread of the virus.
HCA, in partnership with other state agencies — and at the direction of Gov. Jay Inslee — is working to significantly reduce the infected population over the next four years.
Washington State will save money on long-term care by curing those living with HCV, and preventing the spread of the disease. Medicare will save money by curing the younger infected population before they age into Medicare.
HCA is looking at innovative methods to purchase HCV drugs and to ensure timely access to infected Washingtonians.
Through participation in the State Medicaid Alternative Reimbursement and Purchasing Test for High Cost Drugs (SMART-D) collaborative, HCA will develop a four-year drug purchasing budget model and bidding strategy. To do this, SMART-D has compared both current drug prices and amounts budgeted by Washington State to Wall Street analysts’ forecasts of the drug manufacturers’ future stock price.
Historically, Wall Street analysts have provided a realistic assessment of how quickly a drug price will drop due to competition. These assessments are often more realistic than the drug manufacturer’s own predictions about future price.
SMART-D has estimated the drug manufacturers’ expected future revenue for HCV drugs and calculated the portion of those future revenues created from Washington State spending. From these estimates, HCA has a projected future drug price, which we are using to create a drug cost target for the HCV elimination initiative.
In order to achieve HCV elimination in Washington State, the Department of Health (DOH) will convene stakeholders to develop an elimination strategy by July 2019. Stakeholders will include:
- People affected by HCV
- Local health jurisdictions
- Tribal Nations
- Medical providers
- Others with an interest in HCV elimination
HCA will release a request for proposals (RFP) for drug manufacturers to bid on in January 2019. Drug manufacturers will be asked to specify the outreach, screening and medication adherence services they will deploy in support of this state effort.
DOH and HCA are collaborating with other state agencies on these efforts:
- Office of the Governor
- Department of Corrections (DOC)
- Office of the Insurance Commissioner
- Department of Labor & Industries (L&I)
- Department of Social and Health Services (DSHS)