Puerto Rico: Medicaid Subscribers Bereft of Hepatitis C Drugs

Puerto Ricans are some of the only Medicaid subscribers unable to access affordable hepatitis C medications, the Puerto Rico Health Insurance Administration (ASES) said last week.

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A transmittable bloodborne infection, Hepatitis C heightens the risk of cirrhosis, liver cancer, and death. When first introduced, only the most severe cases were offered treatment for their disease and Medicaid only provided one, expensive medication. With further research, the market broadened and Medicaid patients throughout the U.S were offered more affordable alternatives.

However, on the tropical U.S. territory, all but 100 Puerto Rican subscribers are left to battle their diseases alone, struggling with the steep prices of Hepatitis C medication, one of the many treatments not covered by Medicaid insurance.

William Ramirez, the executive director of American Civil Liberties Union of Puerto Rico, told the Kaiser Health News he is considering filing a lawsuit against Puerto Rico for neglecting Medicaid enrollees and failing to facilitate access to affordable medication.

However, reports from the Office of Patient Legal Services show that in 2015, Puerto Rico’s attempted to launch a separate federal program to financially assist patients battling the deadly liver infection. The initiative was eventually forced to close due to lack of funds. Studies show Medicaid is the main contributor to the island’s US$70 billion debt.

A 2017 petition from a Puerto Rican Senate member and physician, Dr. Jose Vargas Vidot, denounced the lack of proper medication through government funded medicare. In November, Vidot pushed for legislation to expand medical coverage to include Hepatitis C treatments.

ASES Director Angela Avila Marrero pursued her own mode of action, targeting drugmakers and requesting the construction of a separate network to open the market and provide medication to all patients. Through this initiative, the ASES director hopes to finagle more affordable prices for the federal program.

Marrero said, "Definitely, (patients) need to be given coverage. They need to be given care."

There were at least 11,000 registered Hepatitis C cases between 2010 and 2016, the Center for Health Law and Policy Innovation of Harvard Law School reports, while an average of nearly three percent of new liver cancer cases is discovered annually.