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March 03, 2016 at 12:32 AM
(Bloomberg) — The New York state attorney general has asked 16 health insurance companies for information on their coverage of hepatitis C treatments, amid concerns that some companies are restricting coverage of the expensive medications, according to a person familiar with the investigation.
Attorney General Eric Schneiderman’s office has issued subpoenas to the health insurers, including Anthem Inc. (NYSE:ANTM), Aetna Inc. (NYSE:AET) and EmblemHealth Inc., requesting documents explaining how they make decisions on who to cover or not, said the person, who declined to be identified because the matter wasn’t public.
See also: Gilead plan kept up hepatitis C drug prices, senators say
The hepatitis C medications, made by Gilead Sciences Inc. (Nasdaq:GILD) and AbbVie Inc. (Nasdaq:ABBV), have been controversial for their price. While the drugs typically cure a patient of the virus in 12 weeks, their list prices are about $1,000 a pill, or about $84,000 for a course of treatment. Insurers then negotiate discounts with the manufacturers. Some insurers have limited access to the drugs, restricting them to the sickest of patients, saying even with discounts they can’t afford the drug.
Expanded coverage
Anthem, which operates the Empire Blue Cross Blue Shield insurance company, said it recently expanded coverage of the hepatitis drugs.
“After several months of ongoing clinical review of the medical evidence and safety concerns surrounding hepatitis C treatments, coverage for Empire Blue Cross Blue Shield employer and individual health insurance plans was expanded for six of the newer oral treatments effective Dec. 7, 2015,” Anthem spokeswoman Jill Becher said in an e-mailed statement.
Aetna and Emblem didn’t respond immediately to e-mails seeking comment after regular business hours. The probe was first reported late Wednesday by the Wall Street Journal.
Leslie Moran, a spokeswoman for the New York Health Plan Association, an industry group, said in an e-mail that the scope of the subpoenas was too extensive.
