AJC Watchdog: First Alert

Keeping watch on those who hold the public trust and money

$30,000-a-month treatments driving up state health care bill

The state agency that delivers government health care to about two million poor and disabled Georgians is asking for about a $215 million boost in spending over the next year and a half, much of it due to rising enrollment in the Medicaid program.

But another huge driver is the cost of relatively new drug treatments, like the super-expensive drugs that can  cure Hepatitis C.

In developing its budget request for the upcoming 2016 session of the General Assembly, the Department of Community Health is requesting $46 million for the Hepatitis C treatments and another almost $6.8 million for  Cystic Fibrosis drugs.

Hepatitis C is a viral infection that gradually destroys the liver. It afflicts about 3 million Americans.

DCH asked for extra money during the 2015 session for the Hepatitis C treatment, which costs $30,000 a month and more than $100,000 to complete. The General Assembly agreed to provide $19.7 million of the $42 million requested. The federal government  is kicking in another $40 million.

DCH Commissioner Clyde Reese said paying big to cure the disease for some patients could save the state money over time.

"If you have that (Hepatitis C), and you wind up three or four years down the road needing a (liver) transplant, that is going to be as or more expensive," Reese said. "So we can make a valid argument that these drugs may wind up saving money."

DCH officials said Medicaid has covered the cost of the Hepatitis C drugs for more than 1,000 patients over the past three years. It projects more than 400 new patients will qualify to use the drugs.

Reese said DCH now has more accurate information on the drug's success rate to use in lobbying the General Assembly for the extra drug money.

Reese said the rising cost of drugs to treat a wide range of diseases is a concern for DCH, which spends more than $13 billion in state and federal funds on health care each year.

"It is not just Hepatitis C, it's not just cystic fibrosis," he said. "I understand there are cancer drugs coming on line that are extremely expensive, there are cardiovascular drugs out there that I have heard are effective that are extremely expensive.

"People are talking about genetic medicine, where the medicine is tailored to that person, and that is going to be extremely expensive. We are going to have to decide what we are going to do about it."

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About the Author

James Salzer has covered state government and politics in Georgia since 1990.