Gilead Sciences reached a deal with Anthem under which the drugmaker's therapy Harvoni (ledipasvir/sofosbuvir) will be offered as the primary option for patients with genotype 1 hepatitis C infection, the US health insurer announced. Anthem said the agreement effectively lowers its hepatitis C treatment costs, adding "we were able to achieve a very competitive rate and a freeze on retail pricing for 2015."
According to Anthem, "favourable pricing" from Gilead along with "clinical differentiators," including simpler dosing, were factors in selecting Harvoni over AbbVie’s Viekira Pak. Harvoni is administered as a once-daily tablet, while Viekira Pak, which combines Viekira (ombitasvir/paritaprevir/ritonavir) and Exviera (dasabuvir), requires the majority of patients to take four to six tablets per day (for related analysis, see ViewPoints: Gilead's new HCV deal suggests some payers may value more than just price).
Anthem noted that Harvoni is covered for members of its affiliated health plans, but declined to comment on the number of customers affected by the deal with Gilead. However, Wells Fargo analyst Brian Abrahams suggested that the decision likely affects about 17 million people covered by its business plans. The health insurer indicated that hepatitis C drugs sit on the highest coverage tiers, which means patients are required to pay for a certain percentage of the drug cost. Gilead has met with criticism after pricing its hepatitis C therapy Sovaldi (sofosbuvir) at $84 000 for a 12-week treatment course. Harvoni costs $94 500 for a similar treatment course, while Viekira Pak's 12-week price is $83 319.
Last month, pharmacy benefit manager Express Scripts announced that it will make Viekira Pak available to all patients with genotype 1 infection after agreeing a "significant discount" with AbbVie, while excluding Harvoni for most patients. However, pharmacy benefit manager CVS Health recently indicated that it reached a deal with Gilead under which Harvoni and Sovaldi will be given exclusive coverage.
According to Deutsche Bank analyst Robyn Karnauskas, Anthem is a client of Express Scripts, covering between 8.5 million and 13.5 million patients. "This news is meaningful in that Anthem -- Express Script's largest customer -- didn’t follow Express Scripts in preferring AbbVie's regimen," remarked Evercore-ISI analyst Mark Schoenebaum. Karnauskas added "we see the Anthem deal as positive, however note that discounts are now key to play in the HCV space."
For further analysis, see ViewPoints: Gilead hits back in HCV price war – but at what cost?
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