How should physicians steward limited resources while ensuring that patients can access needed medicines?

Abstract

Hepatitis C poses public health and fiscal crises for state Medicaid programs trying to respond to this epidemic. Meager funding streams, a lack of negotiating power, and escalating pharmaceutical prices exacerbate the financial strain placed on these programs as they struggle to meet public health priorities. The Louisiana Department of Health has adopted a subscription model for hepatitis C treatment, but costly medications continue to challenge states' capacities to cover patients who need costly drugs.