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Illinois Medicaid restricts who can get ‘game-changing’ hepatitis drug

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By Andrew L. Wang
July 29, 2014

drugsFollowing the lead of other states, Illinois Medicaid officials have put in place tight criteria on prescriptions for Sovaldi, a new drug for hepatitis C with potentially game-changing effectiveness but also a budget-breaking price tag.

A panel at the Illinois Department of Healthcare and Family Services that included Director Julie Hamos this month implemented a set of 25 criteria for prior authorization before it will pay for the drug, a product of Gilead Sciences Inc. with a wholesale price of $84,000 per 12-week regimen, or $1,000 per daily pill.

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