VA to Cover New HCV Drugs for All Veterans

The Department of Veterans Affairs (VA), with new funding from Congress, will offer treatment to all veterans with the hepatitis C virus (HCV). Veterans with HCV will be treated with new medication options regardless of stage of their illness or whether they contracted the virus during their service. This comes after protest over the VA’s former policy which restricted these medications to veterans with advanced liver disease, similar to many private insurance companies and Medicaid programs.

Dr. Chester Good, chair of the VA’s medical advisory panel for pharmacy benefits management noted the goal is “to eradicate as much of the disease as we can.” The VA will start hepatitis C antiviral therapy for 1,100 patients per week, with hopes to increase to 2,000 patients per week by the end of 2016. Skeptics question how the VA will manage to fund the treatment of all veterans in its system. Estimates show that nearly 89,000 veterans have a diagnosis of hepatitis C and have not received treatment, in addition to an estimated 40,000 who may be undiagnosed. With new hepatitis C treatment courses costing upwards of $100,000 per patient, list price of these medications could top $12 billion, not including any potential price discounts for through VA government purchasing.

In addition to concerns of cost, there are also apprehension due to the shortage of medical specialists needed to provide care to veterans seeking treatment. Five medical centers in San Francisco, Ann Arbor, Michigan, Richmond, Virginia, Portland, Oregon, and West Haven, Connecticut will take lead in training and disseminating vital information and expert advice on hepatitis C throughout the VA’s national health system. The VA will also use innovative methods to reach the thousands of patients. Telehealth, which allows long distance patient/clinician interaction and care, will be utilized to address staffing issues across the nation. This will allow for patients in remote areas to have access to top physicians, pharmacists, nurses, and other healthcare professionals. Dr. Alexander Monto, director of the liver clinic at the San Francisco VA Medical Center remarked “we can treat patients from San Francisco, but they don’t have to come to San Francisco.” The VA will also use technology to train small, rural facilities in hepatitis C through videoconferencing.

While questions remain, the news is a promising step toward curing thousands of veterans of hepatitis C.1-2

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