Gov. Charlie Baker's attempt to trim spending with cuts to hepatitis C prevention could be penny-wise and pound-foolish, boosting the demand for costly treatment, forcing the state to shoulder perhaps a larger financial burden, health care watchers say.
"State prevention works and it saves a lot of money on expensive drugs," said Barry Bloom, of the Harvard School of Public Health. "Then, if you don't spend money on expensive drugs, you end up spending even more money on things like liver transplants down the line. Prevention is ... a lot cheaper than both of those options."
He added, "The benefits of prevention are financially — as well as personally — incredibly important."
Baker cut $2.3 million in prevention and care for AIDS/HIV and hepatitis C in his budget proposal earlier this month — a $38 billion plan that includes $1 billion in new net spending at MassHealth.
But hepatitis C is on the rise in Massachusetts, according to Mass.gov, with 200,000 patients in the state and at least $8,000 new diagnoses every year.
Hepatitis C medications can cost nearly $100,000 per 12-week regimen, according to AbbVie, a research-based bio-pharmaceutical company.
Rhonda Mann, a spokeswoman for the Executive Office of Health and Human Services, said, "MassHealth currently pays for treatment for its members, recognizes the importance of the benefits of these treatments and is looking at all options to make them more cost-efficient."
However, she did not say whether federal funds will replace the state cuts, and it is unclear how the $2.3 million in cuts will be divided between HIV/AIDS and hepatitis C funding.
Dr. Raymond Chung, director of hepatology at Massachusetts General Hospital, said hepatitis treatments are highly curative — about 95 percent — but the limitation lies in the astronomical costs.
Viekira Pak, a commonly prescribed medication for patients, runs about $83,000, according to maker AbbVie. Harvoni, another common treatment, costs $94,500.
"The main challenge now that we've got the science is the implementation. That's our most vexing challenge for sure," Chung said. "Preventive measures are helpful in the big picture. Treatment is very expensive, and with prevention you require less money per patient to bring about all over better public health."
He added that MassHealth is "on the hook for a lot of drug costs."
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