With the approval this month of two drugs to treat hepatitis C in children, these often overlooked victims of the opioid epidemic have a better chance at a cure. Kids may have an easier time than adults getting treatment approved, some experts say.
Medicaid programs and private insurers have often balked at paying for the pricey drugs for adults, but stricter Medicaid guidelines for kids may make coverage more routine.
The two drugs approved for pediatric use by the Food and Drug Administration, Harvoni and Sovaldi, both have been highly effective in treating adults with the disease. In two clinical trials of children ages 12 to 17, the drugs eliminated all traces of the virus in 97 to 100 percent of patients, generally in 12 weeks. Trials that test the effectiveness of the drugs in younger children are ongoing.
“It’s great news for our kids,” said Dr. Jessica Wen, medical director for the viral hepatitis clinical care program Children’s Hospital of Philadelphia, which had more than a dozen kids participating in the trials. “Historically every new medication that’s approved for adults, there’s always a lag for pediatrics,” she said, noting that the wait can be as long as a decade.
Insurance coverage may be less problematic for children, experts say. Under federal law, state Medicaid programs must cover “early and periodic screening, diagnostic, and treatment services” for children under age 21 that are necessary to correct or ameliorate physical and mental illnesses.
“The short answer is that [Medicaid] will likely require coverage for all kids regardless of whatever the coverage policies for adults may be,” said Matt Salo, executive director of the National Association of Medicaid Directors.