ARTICLE | Politics & Policy

Medicaid group seeks advice on paying for Sovaldi

April 29, 2014 12:30 AM UTC

A trade group representing Medicaid health plans said the price of Sovaldi sofosbuvir from Gilead Sciences Inc. (NASDAQ:GILD) will have a substantial impact on state Medicaid budgets and said it wants to work with Medicaid directors to figure out how to pay for the HCV drug. The comment came in a letter the Medicaid Health Plans of America (MHPA) sent to Matt Salo, executive director of the National Association of Medicaid Directors (NAMD), a not-for-profit that represents state Medicaid agencies.

MHPA recommended the two organizations form a working group to "help CMS and Congress understand" how states may account for the expense of Sovaldi, including increasing 2014 per member Medicaid plan rates, which were set before the HCV drug was approved in December. Per member rates are paid by both the state and federal government, with the federal share determined by the per capita income in each state. MHPA also noted that uptake of Sovaldi "will make it challenging to establish actuarially sound rates in 2015." NAMD said it is open to creating a working group and said more stakeholders should be involved. ...