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Only the sickest Coloradans on Medicaid get breakthrough treatment for hepatitis C


​It’s not until the final two stages of liver damage that needy Coloradans with the blood-borne hepatitis C virus get access to a life-saving drug with a 90-percent cure rate and an exorbitant price tag.

“You’ve got to be on death’s door before they will treat you,” said David Higginbotham, a Colorado Medicaid beneficiary who contracted the virus 35 years ago while working as a hospital surgical tech. He would take the 12-week medication “in a heartbeat” if the Colorado Medicaid department would cover it, but Higginbotham’s liver “score” is 1 out of 4, and the government insurance plan won’t pay for the medicine until liver scarring has progressed to a score of at least 3.

Now pressure for change is increasing against the state Department of Health Care Policy and Financing, which has restricted access to the breakthrough drug due to its cost. State officials say they must balance the public health issue with the taxpayer expense of paying the prescriptions of the more than 9,000 people with hepatitis C on the government insurance system.