Last month, CMS approved Medicaid state plan amendments for Louisiana and Washington state, thus allowing the states to launch innovative value-based purchasing arrangements. Both states’ programs are aimed at working with partnering drug manufacturers to better handle the high costs for curative hepatitis C treatments, and may be the harbinger of similar initiatives by additional states.
Louisiana “put the bow” on its plan to get hepatitis C treatment to Medicaid enrollees and incarcerated individuals over the next five years via a “Netflix”-like subscription model, a state official tells AIS Health.
On June 26, CMS approved Louisiana’s Medicaid state plan amendment authorizing the state to negotiate supplemental rebate agreements from prescription drug manufacturers, using a “modified subscription” model that initially focuses on antiviral agents for hepatitis C.
Meanwhile, Washington state was scrambling to finalize its agreement with AbbVie in time to launch its hepatitis C subscription-model program for Medicaid by July 1. On June 12, CMS gave the green light to Washington state’s Medicaid state plan amendment proposal to negotiate supplemental rebate agreements involving value-based purchasing arrangements with drug manufacturers.
“It’s clear from the recent developments in Washington [state] and Louisiana that payers are looking for innovative ways to pay for the increasing number of promising but costly medications coming to market, including the curative Hep C therapies,” Academy of Managed Care Pharmacy Chief Operating Officer Cynthia Reilly said in a statement to AIS Health.
“The subscription model is one of several models being implemented in real-world settings,” Reilly said. “It’s hard to say if it will become the dominant model. It’s more likely that we will continue to see experimentation and refinements, including with subscription-based, value-based and outcomes-based models.”