Health Affairs July 1, 2020
Harry Liu, Andrew Mulcahy

In June 2019, Louisiana contracted with Asegua Therapeutics––a subsidiary of Gilead Sciences––to pay a lump sum in exchange for as much of a new hepatitis C regimen as is needed to treat patients in its Medicaid program and correction facilities during 2019–24. If successful, this “subscription” payment arrangement would dramatically broaden how many patients Louisiana can treat per year, while limiting the state’s annual total payment.

While the exact amount of the deal is unknown, Louisiana confirmed it is no more than $35 million per year in the coming five years, which is far less than the state would have paid to treat all hepatitis C patients at the price it was paying without the deal. Meanwhile, Gilead Sciences will...

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