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Express Scripts Says ‘No Thanks’ to Gilead Hepatitis C Drugs, Goes for Cheaper AbbVie Rival

Controversy still surrounds $1,000-a-day pill

According to a report from Reuters, the largest pharmacy benefit manager in the U.S. –– Express Scripts –– has negotiated a cheaper price for AbbVie Inc.’s newly approved hepatitis C treatment Viekira Pak (ombitasvir, paritaprevir, and ritonavir tablets co-packaged with dasabuvir tablets) and, in most cases, will no longer cover Gilead Sciences Inc.’s treatments after trying for nearly a year to win a deeper discount.

Exress Scripts opposed the $84,000 price tag for Gilead’s Sovaldi (sofosbuvir) since the drug was approved a year ago. It said the $1,000-a-day pill, shown to cure hepatitis C in most patients, was unaffordable.

Private insurers generally receive discounts of as much as 20% but Gilead has resisted, bringing in $3 billion in quarterly revenue for Sovaldi this year. The company maintains that Sovaldi and a next-generation version called Harvoni (ledipasvir/sofosbuvir), which was approved in October, will save the U.S. health care system the costs of caring for advanced liver disease in many patients.

A Gilead spokesperson said in an e-mailed statement that the company is continuing to negotiate with Express Scripts.

AbbVie’s Viekira Pak was approved by the FDA on December 19, and the company set a list price of $83,319. But it has agreed to a significantly lower price than Gilead for Express Scripts’ National Preferred Formulary, a list of approved and covered drugs for 25 million Americans.

An estimated 3.2 million people in the U.S. have hepatitis C. Most insurance plans have paid for Gilead’s drugs only for patients with advanced liver disease to limit their exposure to its cost. Express Scripts said the AbbVie agreement will allow it to extend treatment to all hepatitis C patients.

State Medicaid agencies have also limited access to Sovaldi, saying it is too expensive even after they receive a legally mandated 23% discount.

Express Scripts announced that, starting January 1, 2015, it would pay for the AbbVie drug only for patients who have genotype-1 hepatitis C. Express Scripts will no longer cover Gilead’s Harvoni, a one-pill treatment for patients with genotype-1 disease that costs $94,500 for a 12-week course. It will cover Sovaldi in cases where patients have other types of the disease.

Source: Reuters; December 22, 2014.

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