Lakdawalla and his colleagues note that, despite the high cost of novel hepatitis C (HCV) treatments and patients’ apparent willingness to bear part of it, high patient cost sharing is both inefficient and inequitable. HCV treatment is expensive, but it is also extraordinarily effective. Although investing in it imposes real costs on society, those costs are justified by even larger downstream benefits. Insurers are struggling to find ways to afford the costs of treatment, but high cost-sharing arrangements that impose large out-of-pocket expenses on very sick individuals are suboptimal solutions. Instead, the authors say, modestly higher premiums for all beneficiaries can achieve the same financial goals for the insurer, without excessively burdening the sickest and least advantaged members of society.
The full article is available at American Journal of Managed Care.
Citation: Lakdawalla, D. N., Linthicum, M. T., & Vanderpuye-Orgle, J. (2016). Does Patient Cost Sharing for HCV Drugs Make Sense? American Journal of Managed Care.