since 2014, direct-acting antivirals (daa) have dramatically changed the landscape of hepatitis c treatment. these drugs are almost 100 percent effective in curing the disease, with minimal side effects. the course of treatment is also much shorter, 8 to 12 weeks instead of a year.
A concern for people seeking treatment for hepatitis C is cost. when these drugs were introduced, the cost of a full course of treatment could be as high as $100,000 per patient.
Pharmaceutical companies began producing generic versions, driving the price down to $24,000—still a significant cost.
Fortunately, many insurance plans offer coverage for the treatment, and there are several resources available for those in need of financial assistance.
Take the example of Albert Pannell, who received funds to pay for his hepatitis C therapy through Medicare.
symptoms of edema lead to diagnosis
The Baltimore resident found out he had the disease in 2018 after his feet swelled up. “My feet were so bad that I had to take my shoelaces off to walk,” he says.
When he visited nearby Johns Hopkins Hospital for help, the medical team performed a simple blood test to see if Pannell had Hepatitis C.
edema, a swelling of the feet, ankles, or legs due to fluid buildup, is a common symptom of cirrhosis.
“I couldn’t believe I tested positive,” says Pannell, 64. “I was angry, but I thought I probably got the disease from sharing needles because I was once addicted. Today I am 17 years clean.”
After completing eight weeks of antivirals, the Pannell test was performed again. she still had hepatitis c. “I was frustrated and bummed out that it didn’t work,” says Pannell, “but my care provider told me to try again.”
After a second round of therapy, Pannell was cured.
medicare coverage allows treatment success
sherilyn c. Brinkley, a certified registered nurse practitioner and program manager at the Johns Hopkins Viral Hepatitis Center in Baltimore, advised Pannell on caring for her. She says that she was lucky to receive Medicare coverage.
“What came with this incredibly easy, short, and remarkably effective regimen was a really high cost,” says brinkley. “Since then, we have been able to cure thousands of patients here in Baltimore. but we have had to struggle a lot with access to drugs along the way. many still can’t get treatment because of the cost, and that’s a frustrating element of this whole process.”
some limitations depending on the stage of the disease
Some state Medicaid programs place restrictions on who can receive medications based on the stage of fibrosis (scarring).
“Stage 1 is mild, 2 is moderate, 3 is severe, and 4 is cirrhosis,” says brinkley. (Cirrhosis is a condition in which the liver becomes scarred and permanently damaged, according to the National Institute of Diabetes and Digestive and Kidney Diseases.)
arkansas and south dakota, for example, require severe liver damage (stage 3 (f3) liver fibrosis or greater) before someone can receive medication, and texas requires moderate (f2) or greater liver damage before that a person may qualify for treatment, according to a report published in May 2021 by the Center for Innovation in Health Policy and Law at Harvard Law School and the National Viral Hepatitis Roundtable.
Financing resources available for patients with hepatitis c
While Pannell relied on Medicare to cover its costs, patients can turn to a variety of resources to help pay for the expenses associated with hepatitis C treatment.
here is a list of various funding resources.
1. pharmaceutical programs
Even if a patient has insurance, the copay or deductible can be prohibitively high. For those who qualify, pharmaceutical companies offer copay assistance programs to reduce these costs.
They also provide medications free of charge to low-income people who are uninsured or underinsured and do not receive Medicaid or Medicare support.
For more information on program details, talk to your health care provider or insurance company, or contact the pharmaceutical companies directly.
2. the american liver foundation (alf)
alf offers a comprehensive support guide to financial assistance resources and a free drug discount card that can be used for prescription medications.
This organization provides information on thousands of assistance programs to help with drug costs. The website also has a database to locate free and low-cost medical clinics by zip code.
A helpline from this nonprofit organization connects patients with counselors, who provide personal assistance in locating financial resources. they can be reached by calling 877-help-4-hep (877-435-7443).
5. the healthwell foundation
people living with hepatitis c can get copay assistance from the foundation. patients qualify for assistance based on certain eligibility requirements, such as existing insurance coverage and income.
6. Pharmaceutical Research and Manufacturers of America (PHRMA)
This free tool connects patients with resources, such as assistance programs, based on the medications they are taking. they also refer people to free or low-cost health care clinics.
7. The Patient Access Network (PAN) Foundation
pan relies on donations from corporations and caring individuals to help insured people pay high out-of-pocket costs.
8. the patient advocacy foundation
This organization provides copay relief and a directory of national and local resources that can offset some of the financial burden of medical expenses.
“Whatever the cost, the benefit to the person of eradicating hepatitis c today and not having to deal with the complications is immense,” says joseph galati, md, medical director of the center for liver disease and transplantation at the houston methodist hospital.
“The average person may not appreciate the savings of preventing someone from getting liver cancer or a liver transplant or the disability associated with chronic hepatitis c,” says dr. galati. “Whatever the cost of treatment, it’s a drop in the bucket when you look years down the road at the potential cost of living with hepatitis c.”