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How Should Physicians Steward Limited Resources While Ensuring That Patients Can Access Needed Medicines?
Pete Croughan1, Rebekah E Gee2
1A medical student at the University of California, San Francisco, School of Medicine, and previously served as policy director at the Louisiana Department of Health, where he worked on financing for graduate medical education, pharmaceutical policy, analyzing federal health reform efforts, and developing a statewide cancer strategy, and served as chief of staff for the department.
AMA Journal of Ethics
|August 10, 2019
Summary
State Medicaid programs face fiscal crises due to the hepatitis C epidemic. High drug costs challenge treatment coverage, despite innovative models like Louisiana
Area of Science:
- Public Health
- Health Economics
Background:
- Hepatitis C presents significant public health and financial challenges for state Medicaid programs.
- Limited funding, weak negotiating power, and rising drug prices strain program budgets.
- Effective hepatitis C treatment is crucial but faces accessibility barriers due to cost.
Purpose of the Study:
- To analyze the fiscal impact of hepatitis C on state Medicaid programs.
- To evaluate the effectiveness of innovative treatment procurement models.
- To identify challenges in providing universal access to hepatitis C medications.
Main Methods:
- Analysis of state Medicaid expenditure data related to hepatitis C treatment.
- Review of pharmaceutical pricing trends and their impact on state budgets.
- Case study of Louisiana's hepatitis C drug subscription model.
Main Results:
- Escalating pharmaceutical prices create substantial financial burdens for state Medicaid programs.
- Innovative models, such as subscription services, are being explored to manage costs.
- Despite new models, ensuring comprehensive patient coverage for costly hepatitis C drugs remains a significant challenge.
Conclusions:
- Addressing the hepatitis C epidemic requires sustainable financial strategies for state Medicaid programs.
- Negotiating drug prices and exploring cost-effective procurement are essential.
- Continued innovation in treatment access models is needed to overcome cost barriers and improve public health outcomes.
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