Medicaid spent $1.33B on hepatitis C treatments through Q3 2014

April 07, 2015

State Medicaid programs spent $1.33 billion on hepatitis C therapies through the third quarter of last year, or nearly as much as the states spent in the previous three years combined a Wall Street Journal analysis of federal data shows. The growth was primarily driven by Gilead's Sovaldi, which has a wholesale cost of $84,000 per person over the course of treatment. Sovaldi was Medicaid's third-largest drug expenditure after Abilify, an antipsychotic medication that cost $1.73 billion, and a generic version of the cholesterol-lowering treatment Lipitor, which totaled $1.12 billion in spending. In total, states spent $1.08 billion on Sovaldi in the first nine months of 2014, representing 82% of all hepatitis C drug spending, according to the analysis. The second-largest expenditure, at $136.3 million, was for Olysio, a pill made by Johnson & Johnson that was often used in combination with Sovaldi. States are entitled to get a portion of their money back through legally mandated rebates of at least 23.1%. The data analyzed by the Journal doesn't include rebates. Texas, which has the nation's third-largest Medicaid population after California and New York, spent nothing on Sovaldi in the first nine months of the year, according to the data, making it the only state in the U.S. to not pay for the drug. New York, known for offering relatively generous Medicaid coverage, was the biggest spender on Sovaldi during the first nine months of 2014, at just over $297 million, or 7.6% of the state's total drug spending. California spent $86.94 million on the drug.