Insurer Aetna has made new hepatitis C drugs from Gilead Sciences Inc. preferred treatments for customers with the liver-destroying virus.
Aetna Inc. said that it’s reached a deal with Gilead bringing discounts for Sovaldi and Harvoni, which have list prices of about $84,000 and $94,000, respectively, for a course of treatment. The amount of the discount wasn’t disclosed.
Aetna’s decision follows moves by two huge prescription benefit managers, Express Scripts Holdings Co. and CVS Health Corp., to wring big discounts from makers of a new generation of hepatitis C medicines that cure nearly all patients, in as little as eight weeks. Besides Gilead’s medicines, AbbVie Inc.’s combo treatment, Viekira Pak, was launched last month with a list price of about $83,300.
Aetna’s deal affects customers who get their health care coverage from an employer or a health care exchange, or just over 10.8 million people, according to a company spokeswoman.
Patients must go through Aetna’s preauthorization process before they can fill prescriptions for any hepatitis C drugs, including older, less-expensive ones.
Earlier treatment regimens require taking both pills and injected drugs, cause nasty flu-like symptoms and other side effects many patients can’t tolerate, and require treatment for up to a year – yet those regimens still barely cure half of patients.
The new Gilead and AbbVie pills are tremendous improvements. But their eye-popping prices – $1,000 a pill for Sovaldi, for example – have galvanized health insurers and prescription benefit managers to demand big discounts to include the drugs on their formularies of preferred medicines, or to restrict coverage to just one company’s treatments.
That’s because about 3.2 million Americans are infected with hepatitis C, which generally doesn’t cause noticeable symptoms until the liver is damaged. Without proper treatment, up to 30 percent of those people will eventually develop cirrhosis, or scarring of the liver tissue. The virus can cause liver failure and liver cancer, resulting in the need for a liver transplant. That all runs up a much bigger bill than the new medicines will, which is how the drugmakers seek to justify their high prices.
The pushback from payers comes as much of the pharmaceutical industry is focused on developing ultra-expensive medicines – some costing hundreds of thousands of dollars a year – for various cancers, hepatitis C and many diseases that are rare individually, but as a group affect tens of millions of Americans.
Aetna is based in Hartford, Connecticut.
Filed Under: Drug Discovery