Gilead Sciences' hepatitis C drugs Sovaldi and Harvoni are the poster children for out-of-control drug costs, but competition from AbbVie's drug may place downward pressure on these prices.
Gilead Sciences’ hepatitis C drugs Sovaldi and Harvoni are the poster children for out-of-control drug costs, but increased competition may see some downward pressure of costs.
On Monday, Express Scripts updated its formulary to expand access to AbbVie’s new breakthrough treatment for the hepatitis C virus. Viekira Pak was just approved by the FDA on December 19 and determined to be at least clinically equivalent to Sovaldi and Harvoni. Starting January 1, 2015, Viekira Pak will be the exclusive option for genotype 1 hepatitis C, according to Express scripts.
“Pharmaceutical innovation must be rewarded based on the value it brings to patients and payers,” Steve Miller, MD, senior vice president and chief medical officer of Express Scripts, said in a statement. “This agreement marks a fundamental change in how sustainable access and affordability will be delivered to hepatitis C patients."
Viekira Pak will be available for all patients regardless of symptoms or disease. Previously, many US payers were only covering pricier hepatitis C medications for patients experiencing stage 3 or 4 liver disease.
"If the specialty drug trend continues to increase by double digit percentages, payers will be forced to implement even more narrow management tools, thus limiting the number of patients who can afford to receive the drug therapy," said Paula Jakub, chief executive officer/executive vice president of American Foreign Service Protective Association, an Express Scripts client. "It only makes sense for manufacturers to work with payers on pricing decisions. We are delighted to be a partner in this relationship to explore new approaches for the right person to receive the right drug at the right time."
However, the drug is not a huge discount to Sovaldi, which costs $84,000 for a 12-week course of therapy. Harvoni costs $94,500 for 12 weeks. AbbVie has set the price for Viekira Pak at $83,319 for the same length of therapy. However, The New York Times suspects that Express Scripts and AbbVie were able to negotiate a more favorable price with discounts that will help hold down healthcare costs for employers using Express Scripts.
"We want all hepatitis C patients to receive the best care our healthcare system can deliver, but that option simply wasn't possible until today," said Dr Miller.
Care Quality Metrics in Medicare During COVID-19 Pandemic
August 12th 2025Medicare Advantage outperformed traditional Medicare on clinical quality measures before and during the COVID-19 pandemic; mid-pandemic, however, traditional Medicare narrowed the gap on some in-person screenings.
Read More
Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
Listen
Managed Care Reflections: A Q&A With Charles N. (Chip) Kahn III, MPH
July 30th 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The August issue features a conversation with Charles N. (Chip) Kahn III, MPH, the president and CEO of the Federation of American Hospitals and a longtime member of the AJMC editorial board.
Read More
Effects of Adjunctive Cariprazine Formulary Restrictions in Major Depressive Disorder
July 23rd 2025Patients who experienced a formulary-related rejection of cariprazine for adjunctive treatment of major depressive disorder had significantly higher hospitalization rates than those with approved claims.
Read More