Eyeing a $168-million annual price tag for two costly new hepatitis C drugs, state officials hope to limit access to a small fraction of the 20,000 Oregon Health Plan members afflicted by the liver disease.
…Other states by law must cover the drugs for their Medicaid programs. And private insurers are under pressure from Medicare to do the same. But Oregon's state and federally funded program has a special waiver. It lets the state deny routine coverage of drugs for OHP members based on cost and efficacy.