Oregon Medicaid looks to restrict Sovaldi access

Oregon's Pharmacy and Therapeutics Committee proposed guidelines that would restrict HCV drug Sovaldi sofosbuvir from Gilead Sciences Inc. (NASDAQ:GILD) in the state's Medicaid program. The guidelines would allow access only to patients with late stage liver damage, including HCV/HIV co-infected patients with cirrhosis, cirrhotic patients without ongoing progressive decompensation and patients with HCV infection in the transplant setting. In all cases, the proposed guidelines specify that expected survival from non-HCV associated morbidity must be greater than 5 years.

According to a spokesperson for the Oregon Health Authority, treating 30% of the 5,600 known cases of HCV among Oregon Medicaid patients would cost about $168 million -- or about 45% of the annual Medicaid pharmacy budget. A subcommittee of Oregon's Health Evidence Review Commission is scheduled to meet this week to discuss the guidelines. If adopted by the subcommittee, and subsequently approved by the full commission on Aug. 14, the guidelines would come into effect on Oct. 1. ...