Gilead Sciences adds fuel to fire in hep C pricing battle with Anthem deal

Courtesy of Gilead

Gilead Sciences ($GILD) has not wasted any time in its hep C pricing war with AbbVie ($ABBV). Weeks after the Illinois drugmaker struck an exclusive deal with Express Scripts ($ESRX) for its Viekira cocktail, Gilead inked a pact with the PBM's biggest rival, CVS Health ($CVS), to make its Harvoni and Sovaldi available on the payer's main drug list.

Now, Gilead is joining forces with Anthem ($ANTM), the biggest provider of health coverage to U.S. businesses and Express Scripts' largest customer, to make Harvoni the primary option for patients, adding fuel to the fire and setting the stage for a hep C showdown.

Under the deal, patients with the most common genotype of hepatitis C will have to try Gilead's Harvoni first. The company's "favorable pricing" and "clinical differentiators" such as simpler dosing convinced Anthem to choose Harvoni over AbbVie's Viekira Pak, the insurer told Bloomberg, but neither side is commenting on pricing discounts. Gilead's Harvoni, which combines Sovaldi and another medication, is taken as a single pill and runs at $94,500 for 12 weeks of treatment. AbbVie's Viekira Pak rings in at $83,319 for a 12-week dose.

The agreement marks a big win for Gilead as it continues to fend off competition from AbbVie's rival hep C med. Anthem's employers plans served about 30 million people in the U.S. in 2013, more than any other for-profit insurer, Bloomberg notes, providing a greater reach for the Gilead as it pushes for additional coverage of its next-gen drug. The news also comes as a surprise to investors, as Anthem did not follow in Express Scripts' footsteps and choose to cover AbbVie's regimen.

Express Scripts CMO Steve Miller

But the deal could signal a broader drug pricing blitz, as pharma companies ink exclusive agreements with PBMs that demand large discounts for top-selling meds in return. "We're going to see a lot more of this" in other drug categories, including multiple sclerosis or rheumatoid arthritis, Roger Longman, CEO of drug reimbursement analytics firm Real Endpoints, told Bloomberg. The next target for payers could be experimental PCSK9 heart drugs that reduce bad cholesterol in patients, or pricey "CAR-T" cancer immunotherapies that may run upward of $350,000.

Meanwhile, payers are watching the Gilead/AbbVie hep C pricing battle with bated breath before reaching their own coverage decisions. Molina Healthcare CEO Dr. J. Mario Molina said in April that his company would "be taking a very serious look at this." Express Scripts CMO Steve Miller, a vocal critic of skyrocketing drug prices, said he hopes other payers follow his company's lead.

"There would be no discounts if we hadn't done what we did," he said earlier this month after CVS forged a deal with Gilead for Harvoni. "We found a partner in AbbVie that changes the whole dynamic. Today's decision from CVS is a natural extension of the good work that we've done."

- read the Bloomberg story

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