The FDA approval and release of treatments for hepatitis C in late 2013 were a game changer in the treatment of this disease. But the price tags caught self-insured employers off guard. Previously, those suffering from chronic hepatitis C were resigned to complex treatment regimens associated with severe side effects and efficacy rates of less than 50%. The launch of Sovaldi and other therapies paved the way towards a shorter and simplified means to a cure for these patients. This new class of specialty medications was both extremely promising and extremely expensive: for some, prohibitively so.
Now, fast forward to 2018: after Sovaldi and Harvoni took the marketplace by storm, additional hepatitis C treatments followed, broadening the treatment scope by addressing other subtypes of the disease. Hepatitis C drug prices are trending downward as lower-cost options and soon, generics enter the market. Faced with increased competition and public scrutiny for their exceedingly high launch prices, U.S, manufacturers have started to drop their list prices to maintain market share and viability.
Gilead took the bold step of releasing its own generic versions of Harvoni and Epclusa in January 2019, a full decade before their patents expire. Gilead CEO John Milligan wrote in a company statement:
“Over the past several months, we have searched for a viable path to reduce the list price of our branded HCV medications so that their cost to payers is more easily understood. Unfortunately, existing contracts with insurers, together with laws associated with government pricing policies, make it unacceptably difficult to quickly lower the list price to reflect the discounted cost of our medications.”
It remains to be seen how the market responds to these generics’ release, particularly from a plan design perspective. These price reductions are just one more example of the system moving slowly in the right direction. With this continuously changing landcape, employers should frequently revisit their preferred drug strategy with respect to hepatitis C.
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