VA Extending Hepatitis C Therapy as its drug spend for the disease increases rapidly.
The department last year allocated $696 million for new hepatitis C drugs, accounting for 17 percent of the VA’s total pharmacy budget. In fiscal 2016, which began Oct. 1, 2015, the VA expects to spend about $1 billion on hepatitis C drugs. The department has requested $1.5 billion in its next-year’s budget for the hepatitis C treatments and clinical resources.
Responding in part to a budget shortfall caused by expensive Hepatitis C drugs and non-Choice community care, Congress passed the VA Budget and Choice Improvement Act on July 31, 2015.
It mandated that all VA community programs be combined under the Veterans Choice Program and, in a potentially large expansion, opened Choice to veterans enrolled in VHA after August 1, 2014.
VA’s answer to the law (with considerable stakeholder input) was a plan to reorganize administrative function and make community care an integral part of the VA offering. There will also be some new twists. For one, community care will be tied to a 40-mile distance from a facility with a primary care physician (bolstered in many instances by VA medical homes called PACTs), rather than from a Medical Center per se.
The first phase of the Veterans Choice Program (one year) involves developing the plan and implementing minimal viable solutions, such as standardized sharing agreements. The second phase (one year) will involve rolling out care, and the third phase (time unspecified) will involve deployment of integrated systems, high-performance networks, data-driven improvements, et cetera.
As a result of the new plan and aided by new funds from Congress, the VA is extending new antiviral treatments to all veterans with hepatitis C treated within its sprawling health care system—regardless of the stage of their illness and whether they contracted these infections during military service.
The VA is beginning Hepatitis C antiviral therapy for 1,100 patients a week, doubling its efforts over the past year. The VA hopes to increase that number to 2,000 patients a week by the end of 2016.
Additional information included in AMI’s Government Healthcare report, published in August 2016