One concern for people seeking treatment for hepatitis C is cost. When these medications were introduced, the cost of one full treatment course could reach about $100,000 per patient. Pharmaceutical companies began producing generic versions, which lowered the price to $24,000 —still, a significant cost. Fortunately, many insurance plans offer coverage for the treatment, and several resources are available for those who need financial assistance. Take, for instance, Albert Pannell, who received funding to pay for his hepatitis C therapy through Medicare.
Edema Symptoms Lead to Diagnosis
The Baltimore resident found out he had the disease in 2018 after his feet swelled up. “My feet were so bad, I had to take the shoestrings out of my shoes so I could walk,” he says. When he visited nearby Johns Hopkins Hospital to get help, the medical team conducted a simple blood test to see if Pannell had hepatitis C. Edema, a swelling of the feet, ankles, or legs due to a buildup in fluids, is a common symptom of cirrhosis. “I couldn’t believe I tested positive,” says Pannell, 64. “I was mad, but I figured that I probably got the disease from sharing needles because I was an addict at one time. Today, I’m going on 17 years clean.” After completing eight weeks of antivirals, Pannell was retested. He still had hepatitis C. “I was frustrated and discouraged that it didn’t work,” says Pannell, “but my care provider said let’s try it again.” After a second round of therapy, Pannell was cured.
Medicare Coverage Allows for Treatment Success
Sherilyn C. Brinkley, a certified registered nurse practitioner and a program manager at the Johns Hopkins Viral Hepatitis Center in Baltimore, advised Pannell on his care. She says he was fortunate to receive Medicare coverage. “What came with this incredibly easy, short, extraordinarily effective regimen was a really high cost,” Brinkley says. “Ever since then, we’ve been able to cure thousands of patients just here in Baltimore. But we’ve had to really struggle with access to drugs along the way. Many are still not able to get treated because of the cost, and that’s a frustrating element of this whole process.”
Some Limitations Based on Stage of Disease
Some state Medicaid programs place restrictions on who can receive the drugs based on the fibrosis (scarring) stage. “Stage 1 is mild, 2 is moderate, 3 is severe, and 4 is cirrhosis,” says Brinkley. (Cirrhosis is a condition in which your liver is scarred and is damaged permanently, according to the National Institute of Diabetes and Digestive and Kidney Diseases.) Arkansas and South Dakota, for example, require severe liver damage — stage 3 liver fibrosis (F3) or greater — before someone can receive medication, and Texas requires moderate liver damage (F2) or greater, before a person can qualify for treatment, according to a report published in May 2021 by The Center for Health Law and Policy Innovation of Harvard Law School and the National Viral Hepatitis Roundtable.
Funding Resources Available to Hep C Patients
While Pannell depended on Medicare to cover his costs, patients can turn to a range of resources to help pay for the expenses associated with hepatitis C treatment. Here is a list of several funding resources.
1. Pharmaceutical Programs
Even if a patient has insurance, the copay or deductible may be prohibitively high. For those who qualify, pharmaceutical companies offer copay assistance programs to reduce these costs. They also provide medications free of charge to lower-income individuals who are uninsured or underinsured and are not receiving support from Medicaid or Medicare. To find out more about program specifics, speak to your healthcare provider or insurance carrier, or contact the pharmaceutical companies directly.
2. The American Liver Foundation (ALF)
ALF offers a comprehensive financial assistance resource support guide and a free drug discount card that can be used for prescription medications.
3. NeedyMeds
This organization provides information on thousands of assistance programs that help with medication costs. The website also features a database to locate free and low-cost medical clinics by ZIP code.
4. Help-4-Hep
A help line from this nonprofit connects patients with counselors, who provide personal help locating financial resources. They can be reached at 877-HELP-4-HEP (877-435-7443).
5. The HealthWell Foundation
Individuals living with hepatitis C may get copay assistance from the foundation. Patients qualify for assistance based on certain eligibility requirements, such as existing insurance coverage and income.
6. The Pharmaceutical Research and Manufacturers of America (PhRMA)
This free tool matches patients with resources, such as assistance programs, depending on what medications they are taking. They also refer people to low-cost or free healthcare clinics.
7. The Patient Access Network (PAN) Foundation
PAN relies on donations from corporations and caring individuals to help insured people pay high out-of-pocket costs.
8. The Patient Advocate Foundation
This organization provides copay relief and a directory of national and local resources that can offset some of the financial burden of medical expenses. “Whatever the cost, the benefit to the person to eradicate hepatitis C today and not deal with complications is immense,” says Joseph Galati, MD, medical director for the center of liver disease and transplantation at Houston Methodist Hospital. “The average person may not appreciate the savings from preventing somebody from getting liver cancer or a liver transplant or the disability associated with chronic hepatitis C,” says Dr. Galati. “Whatever the cost for treatment is, it’s a drop in the bucket when you look years down the line as far as the potential cost of living with hepatitis C.”
