Express Scripts praises, then takes credit for Gilead's authorized generics launches

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Express Scripts praised Gilead's move to launch authorized generics of its own hepatitis C drugs. (Express Scripts)

With its hepatitis C franchise suffering from pricing pressure, Gilead Sciences has unveiled a plan to release authorized generics to its own medications at a fraction of the price. Due to drug market dynamics, the tactic could actually reach new patients and potentially grow sales.  

Now, Express Scripts is taking credit for the idea. In a post after Gilead’s announcement, the pharmacy benefit giant said it suggested such a move in its response to the Trump administration’s drug pricing blueprint, released in May.

Express Scripts—which has tussled with Gilead over drug pricing before—said Gilead's announcement is “a step in the right direction, and we are encouraged that a drug maker is taking meaningful action to bring prices down for cash-paying customers.” 

Under its plan, Gilead will sell authorized generics of Eplcusa and Harvoni at a list price of $24,000, a significant discount to Epclusa’s $74,760 sticker price and Harvoni's $94,500. Due to high rebates in the hep C drug class, actual prices for the branded and generic meds will be “similar,” Gilead CEO John Milligan said in a post explaining the plan. The authorized generics could save patients up to $2,500 out of pocket per course of drugs.

As government and industry have examined potential changes to drug pricing this year, Express Scripts did indeed suggest a similar approach. Back in July, in response to the Trump administration’s pricing blueprint, Express Scripts’ vice president of corporate government affairs Jonah Houts wrote to Department of Health and Human Services Secretary Alex Azar that the administration “could encourage some drug makers to reintroduce their products as competing brand drugs." As Houts wrote at the time, list price decreases pose challenges. 

But, he wrote, “should the Administration allow drug makers to introduce competing brands of their own drugs with lower list prices, uninsured Americans would benefit immediately.” The Express Scripts exec explained that patients with high deductible plans would “immediately have new treatment options” and that the entire system could shift to the “new pricing model over time.” 

Although Express Scripts praised Gilead’s recent move, the companies have had a contentious history in hep C. Under scrutiny after Gilead released Sovaldi and Harvoni at list prices of $84,000 and $94,500, respectively, a former exec for the company said pharmacy benefit managers and payers prefer high list prices and high rebates. An Express Scripts exec quickly shot back and not only disputed the claim but asked for repayment on the drugs.

Before that skirmish, Express Scripts Chief Medical Officer Steve Miller held firm against Gilead’s hep C pricing. When AbbVie launched a competitor, Express Scripts struck a deal with that company; Miller said the tactic saved billions in drug costs. 

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