State settles Medicaid suit over cystic fibrosis drug | Arkansas Blog

Friday, February 6, 2015

State settles Medicaid suit over cystic fibrosis drug

Posted By on Fri, Feb 6, 2015 at 12:05 PM

The state Medicaid office has settled a federal lawsuit brought by three cystic fibrosis patients who were denied the drug Kalydeco because of cost, the Wall Street Journal reported yesterday. 

Catherine Kiger, Elizabeth West and Chloe Jones filed the suit, Kiger v. Selig et al, last year saying the state had violated their civil rights for two years by denying them the drug.   was filed Thursday in federal court in Fayetteville.

Kate Luck, a spokesperson for the state Department of Human Services, said the settlement involved no monetary awards, but the state, which changed its criteria for eligibility for the drug prior to the settlement, has agreed not to change those criteria for two years. Should the state deny the drug to a Medicaid patient, it must provide the court reasons why and the court may  jurisdiction over the state's decision. ask the state "to outline the reasons for denial," Krell said. 

The courts do not have jurisdiction over the decision. The only thing they can do is ask us to outline the reasons for denial.

The state previously had required the patients to prove that less expensive therapies had failed to work and,   according to the WSJ, "patients seeking to have their prescriptions reauthorized by Arkansas Medicaid were required to prove they had better lung function, weight gain and fewer hospitalizations with the drug."

The state no longer requires the patients to use the standard therapy (Pulmozyme and hypertonic saline) for 12 months before being considered for Kalydeco or to show evidence of failure on the standard therapy, Luck said. She said the studies were "made in response to more recent studies that were released on the drug. Arkansas has covered Kalydeco since 2012 and approved its first patient for coverage in 2013."

The manufacturer of Kalydeco, Vertex, of Boston, had declined to provide the drug free through its patient-assistance program. The drug targets a specific genetic cause of CF, and Luck said the state estimates that only seven CF patients in the state Medicaid program whose disease is caused by the particular gene mutation. While Luck said the denials were not "necessarily because of cost," she added that that the drug is "very expensive" and a "lifetime drug."

The annual wholesale cost of the drug is $311,000, according to the WSJ.

Tags: , ,


Sign up for the Daily Update email
Favorite

Comments

Subscribe to this thread:

Add a comment

More by Leslie Newell Peacock

  • Remains found in West Little Rock park could be Ebby Steppach's

    Though no identification has been made, human remains found in the West Little Rock park where Ebby Steppach's car was located in 2015 could belong to the missing teenager.
    • May 22, 2018
  • Two more deaths at Arkansas prisons

    The Department of Correction reported Sunday the deaths of an inmate at Brickeys, the East Arkansas Regional unit of the Department of Correction, and an inmate at the Varner unit in Grady, both in single-man cells, within 12 hours of one another.
    • May 21, 2018
  • 3rd Friday in Argenta means Art Walking

    There's new public art in Argenta that celebrates the North Little Rock's once-hated, now-embraced moniker "Dogtown." The sculpture was designed by Terry Bean and fabricated of steel. The Argenta Arts Foundation provided the photo above, plus information on tonight's art offerings, 5-8 p.m. on Main Street:
    • May 18, 2018
  • More »

Readers also liked…

  • Arkansas: Land of .......

    Welcome to Arkansas: Land of cowardly politicians, discriminatory laws, inhumane turkey drops and lots and lots of Trump voters.
    • Oct 8, 2016
  • Latest Obamacare repeal bill would hit Arkansas treasury hard

    The latest effort to undo Obamacare, the Graham-Cassidy legislation, would shift federal support for health coverage to a block grant system to the states. Bad news for Arkansas.
    • Sep 18, 2017
  • UPDATE: Hutchinson moves to cover himself on cut to War Memorial Stadium

    Gov. Asa Hutchinson apparently felt the burn from KARK's exclusive Tuesday night on his plans to cut state support of War Memorial Stadium in half beginning July 1, 2018. He has a so-far secret plan to make the stadium self-sustaining. We bet that doesn't include state support.
    • Oct 20, 2016

Most Viewed

Most Recent Comments

Slideshows

 

© 2018 Arkansas Times | 201 East Markham, Suite 200, Little Rock, AR 72201
Powered by Foundation