Prisoners accuse Massachusetts of barring them from pricey hep C meds

New hep C meds have drawn their fair share of criticism, with lawmakers, patients and payers claiming that the drugs' hefty price tags unfairly restrict their use to the sickest patients. Now, more voices are joining the swelling chorus of discontent as two inmates are suing the Massachusetts state prison system for not providing the drugs to prisoners.

As The Wall Street Journal reports, Prisoners' Legal Services, a nonprofit advocacy group, filed the suit on behalf of Massachusetts prisoners Emilian Paszko and Jeffrey Fowler, and is also seeking a class-action suit to include more inmates infected with hep C who have been denied treatment by the system. According to the lawsuit, more than 1,500 inmates in Massachusetts state prisons have the disease, but only three are being treated for it. And the high costs of drugs from companies such as AbbVie ($ABBV) and Gilead Sciences ($GILD) are partly to blame, the suit alleges, with prisons choosing not to approve treatment when faced with sky-high prices. AbbVie's Viekira Pak runs at about $83,300 for a 12-week course, and Gilead's Sovaldi costs about $84,000.

But the hep C meds also offer a new standard of care, the suit claims, one that the prison system is choosing to overlook. Drugmakers are quick to point to the treatments' cost-effectiveness, with recent data showing the meds could potentially cure the disease or reduce complications further down the line. And the benefits of the drugs could be especially far-reaching for prison inmates who have a higher rate of infection than the general population, the WSJ story notes.

"Where it's been particularly troubling is, some of them are very sick," Joel Thompson, staff attorney with Prisoners' Legal Services, told the newspaper. "We're talking about the new standard of care. A lot of times when there's a new standard it takes a while for it to filter down to corrections. But there's too many people with hep C in the system and some number of them can't wait that long."

But the lawsuit is only the tip of the iceberg when it comes to hep C pricing pushback. Some state Medicaid programs are still limiting access to the drugs to individuals with advanced forms of the disease.

And patients are lashing out at private insurers that are choosing not to cover the meds. Last month, a California plaintiff sued Anthem Blue Cross, claiming her plan denied her treatment with Gilead's $95,000 Harvoni because she wasn't sick enough to qualify under its rules.

Meanwhile, hep C drugmakers continue to face backlash from PBMs and lawmakers over skyrocketing prices for the meds. Express Scripts ($ESRX) CMO Steve Miller ignited a pricing war last year by selecting AbbVie's Viekira Pak as its preferred hep C treatment. Gilead struck back with a few deals of its own, but there could be tougher price negotiations ahead as other drugmakers prepare to launch in the hep C market.

- read the WSJ story (sub. req.)
- here's the lawsuit (PDF)

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