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The sticker price for one 12-week course of Harvoni came in at nearly $100,000. Worried a run on the medicine could bankrupt Medicaid programs, states set limits to treat only the sickest first, said Matt Salo, executive director of the National Association of Medicaid Directors. "This is all a balancing act," he said. "Over time, as the drug price has gone down, as the fear of everyone with a condition showing up to demand treatment hasn't exactly borne out ... you are seeing pretty much every state loosen some, many or all criteria." Alam, Peyton’s doctor, is one of those leading that push in Texas. Federal records show he was paid more than $220,000 by one hepatitis C drug maker, Gilead Sciences, and received nearly $27,000 from another, AbbVie, last year. National Public Radio first reported this week on payments from drug makers to doctors nationwide who advocated for Medicaid to cover their products. Related: Lawmakers question state leaders, company executives over reported failures in Medicaid managed care program Alam said part of the money was for research and doesn’t affect his advocacy, or his decisions on patient care. “I choose the drug that is the most appropriate for the patient,” he said. Texas has loosened some restrictions for Medicaid patients, who include low-income children, mothers and adults with disabilities. They no longer need a prescription from a specialist, for example, which was a hurdle for people in rural areas.
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