Texas reconsiders Sovaldi limits

After consulting with outside advisers, the Texas Health and Human Services Commission mulls changing its recommendation to Medicaid that Gilead Sciences' (GILD +3.9%) Sovaldi be restricted to the sickest hepatitis C patients due to its high cost. The plan's July start is now on hold while the agency examines its options.

Also on hold is the state's plan to make supplemental payments to insurers to partially offset the drug's cost.

Insurers in California and Florida have also asked their states to pay them directly so they can avoid losing money in their contracts. California is still evaluating the issue while Florida has no plans to carve out the drug.

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Comments (11)
  • bgold1955
    , contributor
    Comments (2357) | Send Message
    Good idea, let's wait until "advanced liver disease" occurs & not resolve the issue before then.
    11 Apr 2014, 01:29 PM Reply Like
  • anilizer
    , contributor
    Comments (4) | Send Message
    If access was restricted to the sickest patients only, then a huge population of patients would progress to end stage liver failure and require transplant at a cost of 1.50 to 2 mil. Not to mention the human suffering and continued expenses of not getting treated. This idiocity of treating the sickest only would result in catastrophic costs to healthcare system, ad defeat the purpose of curing and eradicating the disease. Once a patient gets to sick to handle treatment, its all over for them, unless they are lucky enough to find a liver donor compatible.
    11 Apr 2014, 01:49 PM Reply Like
  • ajax133
    , contributor
    Comments (456) | Send Message
    Very bullish news ! For every 15,000 patients GILD treats they garner $1B
    in revenues. If they do only 15,000 patient's this year that translates into
    $9B / YR. The biggest issue with GILD was rapid uptake and running out of
    patients before 2019. Curious that no one has mentioned ROW. There are
    4+M patients in The Eurozone, 2M Hep C positive patients in Japan, and they
    have the highest incidence of Liver Cancer 2ndry to Hep C. There are 200M
    infected patients in China. A most conservative estimate of .5% of patients
    treated would be a modest $100B. Amazing how conservative Sell Side numbers
    are. I believe GILD will crush numbers on May 2 2014. I've modeled $1.75B for
    Q1 and $8+B for the year. Texas ought to look into the cost of Rx for Liver Cancer
    and the cost of transplants.
    11 Apr 2014, 02:27 PM Reply Like
  • bgold1955
    , contributor
    Comments (2357) | Send Message
    If it were a corporation, it would.
    11 Apr 2014, 03:11 PM Reply Like
  • MineMan
    , contributor
    Comments (601) | Send Message
    Is this what the Republicans used to refer to as death panels?
    11 Apr 2014, 02:50 PM Reply Like
  • tipper 1
    , contributor
    Comments (332) | Send Message
    OK I get it. Once you are diagnosed with Hep C, lets see how long until you are almost dead and then see if Sovaldi can cure your problems. That way it would be cheaper.Who are these idiots and how did they ever get the positions that they hold? These people cant be doctors....I sure hope they arent
    11 Apr 2014, 07:18 PM Reply Like
  • Teriee
    , contributor
    Comments (109) | Send Message
    Crooked government....worse than you can even imagine
    11 Apr 2014, 08:28 PM Reply Like
  • sharpen
    , contributor
    Comments (6) | Send Message
    Insurance is only for those who never have a claim!
    12 Apr 2014, 07:42 PM Reply Like
  • Spitfire90
    , contributor
    Comments (2) | Send Message
    Gilead paid $11 Billion for this drug! Why be upset at them!
    I need this drug very soon! How many cancer patients get $1K a day meds?
    I hAve done everything I could keep up with Obummer care!
    Let's see what Kaiser does. Once the Govmnt involved in my medical business..I began to see changes immediately, NOT for. The better in my case!
    14 Apr 2014, 01:00 PM Reply Like
  • me, myself, and i
    , contributor
    Comments (20) | Send Message
    The rationale is that the competing drugs arriving 9 months later will be cheaper.. yeah.. sure.. maybe.. by what... $1000 per regimen? Why would Abbvie or whoever's next cut their own throats by getting into a price war with GILD? Not likely. With as many patients out there as there are, there's more than enough business to go around and I see this more as a Coke vs Pepsi scenario rather than some kind of race to the bottom on pricing. While I certainly understand the dilemma, the solution flies in the face of the notion of the top priority being the patients well being and puts economics in first place, and maybe it should be. But if that's the case we're getting into the thorny debate about who pays in what, and who gets out what, if the economics are running the show. At that point we'll just organize the queue according to who's paid what's needed into the system to warrant this pay out. Simply telling everyone that they have to wait until prices come down is unfair to everyone, especially those who paid into the system (taxed in one form or the other) dearly.
    15 Apr 2014, 06:40 PM Reply Like
  • combatcorpsmanVN
    , contributor
    Comments (1390) | Send Message
    $GILD - It never ceases to amaze me about how politicians think. "How can we 'dapple' in things we don't understand" mentality. Here we have a disease that is a monstrous way to die when the Liver is attacked by HEP C. Here we have what may be characterized as a CURE but due to the cost, all else fails in the analysis. Meanwhile, back at the ranch, tax revenue is squandered in a myriad of 'projects' that are only on the drawing board because some lobbying interest group needs to be repaid, as a thank you, for dumping a ton of money in some politician's re-election campaign.


    Genocide is a horrible word to describe a horrible scenario of benign neglect in failing to do something about a gross injustice. Well, watching people die in a miserable way and questioning the cost of a Cure is a modern day version of genocide imo.


    Forget the damned cost and let this breakthrough drug (Sovaldi) be available to everyone afflicted that will ultimately die in a very sad and suffering way.
    16 Apr 2014, 11:47 AM Reply Like
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