Hepatitis C patients often have to get sicker before insurance will pay for drugs

Patients infected with hepatitis C are finding that having private health insurance doesn’t always mean they can get the drugs likely to cure them.
Many insurers in Massachusetts, worried about the high cost of those medications, allow their use only for patients whose livers already show signs of severe damage, despite guidelines from major medical societies recommending treatment for nearly everyone infected with hepatitis C.
As the debate rages over the high prices of drugs such as Sovaldi and Harvoni, the focus has often been on the obstacles to care in state Medicaid programs, which cover a high proportion of people with hepatitis C.
But as John Tortelli of Arlington can attest, patients with private health plans can also be blocked from getting those drugs. His insurer is Tufts Health Plan, which his doctor says has some of the most restrictive policies on hepatitis C drugs.