Hepatitis C patients may be newly eligible for Medicaid coverage

Oct. 4--Charleston -- State health officials say some low-income West Virginians with Hepatitis C may be newly eligible for coverage of their treatment.

West Virginia has one of the highest rates of Hepatitis C in the country, a symptom of the ongoing drug addiction epidemic. Particularly at risk are those who inject drugs, as well as people born between 1945 and 1965. Spread through contaminated blood, Hepatitis C is a viral infection that can lead to liver failure and death, but is curable with treatment.

In 2016, the most recent year for which data was available, there were more than 6,000 West Virginians living with the condition, according to the state Department of Health and Human Resources.

During a meeting of the state Medical Services Fund Advisory Council in Charleston on Friday, Dr. James Becker, medical director of the DHHR Bureau for Medical Services, told the group that Medicaid, a state/federal health insurance program for low-income people, previously covered treatment for Hepatitis C patients in order of priority.

The first drug to treat Hepatitis C, Sovaldi, hit the market in 2013, according to Becker. He said initially patients required 90 tablets and the manufacturer charged $1,000 for each tablet, totaling $90,000 per patient. But more companies have entered the market since then and treatment now ranges from about $11,000 for the course of treatment to around $20,000, according to Becker.

He said before covering treatment, Medicaid officials prioritized based on the severity of the patient's condition by the patient's degree of fibrosis, meaning scarring of the liver. Now, those showing no signs of fibrosis may be eligible.

The change began Oct. 1. In an interview following the meeting, West Virginia Bureau for Medical Services Commissioner Cindy Beane encouraged Hepatitis C patients to contact their doctors' offices to determine if they are newly eligible.

The patients' doctors will have to verify to Medicaid that the patient isn't currently dependent on drugs or alcohol.

The Hepatitis C must be defined as chronic, meaning after six months the body hasn't cleared itself of the infection.

Hepatitis C may have no symptoms but may present with jaundice, fever, muscle aches, fatigue and nausea. Testing is offered at local health departments.

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