Magazine article Drug Topics

PBMs, Insurers Strike Deals for Hepatitis C Drugs

Magazine article Drug Topics

PBMs, Insurers Strike Deals for Hepatitis C Drugs

Article excerpt

Catamaran is the latest PBM to cut a deal for lower-priced hepatitis C treatments for its customers.

At the beginning of February, Cata- maran added Gilead Sciences' hepatitis C treatments, Harvoni and Sovaldi, to its national and value formularies, making these drug therapies the exclusive options for patients with hepatitis C.

Catamaran's decision came a month after CVS/Caremark struck a similar deal with Gilead Sciences to add Harvoni and Sovaldi to its formulary as exclusive options for patients with hepatitis C. Prime Therapeutics LLC added Harvoni to its preferred drug list in January, but it has placed AbbVie's Viekira Pak on its formulary too.

"Prime carefully evaluated all options, including an opportunity for an exclusive agreement with each company,'' said David Lassen, PharmD, chief clinical officer, Prime. "However, placing both Harvoni and Viekira on our formulary proved to be the lowest-cost option for our clients and, importantly, prevents member disruption. We are pleased with the agreements we have signed with both companies and feel we're positioned well for the future in hepatitis C treatment."

Price-point pushback

Express Scripts led the challenge of hepatitis C drug pricing back in April 2014. Express Scripts Chief Medical Officer Steve Miller, MD, told 400 of his biggest clients that "Express Scripts would not stand for unfair chug pricing," referring to the high price of Gilead Science's Sovaldi, a breakthrough treatment for hepatitis C. Each tablet was priced at $1,000; when Sovaldi was used in combination with other medications, the price tag for treating one patient came close to $150,000.

"For the first time in the history of pharmaceuticals, we were seeing orphan-drug pricing for a non-orphan drug. And the total cost impact was going to be devastating for the U.S. healthcare system," Miller said in the company's "Insights/Specialty Medications" report, posted Jan. 27.

Express Scripts negotiated a contract with AbbVie, the manufacturer of Vieki- ra Pak, which also achieved exceptional cure rates and adherence rates.

"AbbVie shared our goal of finding a price that would be both sustainable and also open-access to patients who previously weren't able to be treated," Miller said.

Discounts and rebates

Not only have the nation's largest PBMs struck deals with the manufacturers of these breakthrough therapies for hepatitis C; so have insurance companies. …

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