Gilead discounts hep C meds in Germany, offers new-and-improved generics deal in India

Gilead Sciences ($GILD) has been negotiating all over the place. The U.S.-based drugmaker reportedly inked its first hepatitis C discount deals in Germany, and it's announcing a new offer to bring a Sovaldi follow-up to India even before it's approved in the U.S.

On the one hand, Gilead's German discounts illustrate the increasingly tough environment for high-priced meds, even particularly effective ones like Gilead's Sovaldi and Harvoni. According to the German news magazine WirtschaftsWoche, Gilead has negotiated money-off arrangements with four of the country's state health insurers. The German deals follow a money-off contract in France, and come amid frenzied negotiations with U.S. payers as Gilead and AbbVie ($ABBV) lock up deals for their competing treatments.

The German discounts will be taken off its list price in that country, which is €60,000 (about $67,000) for each drug, Reuters reports. Like discounts arranged with the U.K.'s National Institute for Health and Care Excellence (NICE), Germany's pricing deals are closely watched in other countries.

And more negotiated deals are likely to follow, said Carsten Nowotsch, Gilead's top exec in Germany. "Thirty-five percent of people with statutory health insurance are already profiting from the discount agreements," Nowotsch told the news service.

On the other, ongoing talks with officials in developing nations underscore the pressure on Gilead to provide its vaunted treatments to poor patients at accessible prices. Under criticism despite international deals for cheap generic versions of Sovaldi, the single-agent pill that hit the U.S. by storm last year, Gilead is now offering an as-yet-unapproved pill to Indian officials for a hep C treatment campaign.

Gilead's Gregg Alton

The follow-up to Sovaldi--combining that drug with the experimental GS-5816--delivers high cure rates regardless of the viral genotype patients are carrying, Gilead EVP Gregg Alton told Bloomberg. That's a boon in the developing world, where genotype testing presents a barrier to proper treatment. "It's an expensive diagnostic that's simply not available many places," Alton told the news service.

The company licensed Sovaldi to 8 Indian generics makers last year, in a deal aimed at getting the drug into 91 poor nations at cut-rate prices. The company plans to launch Sovaldi in India by mid-year, at a $900 price per treatment course, which is a small fraction of its $84,000 list price in the U.S. Patient advocates say the generics deal leaves out middle-income countries where Gilead's meds will remain too expensive for many patients, and pricing in poor countries may keep the drugs out of reach there, too.

In this latest arrangement, Gilead will let the Indian drugmakers in on a combo of Sovaldi and GS-5816 now, if health officials there allow the drug to market before clinical trials wrap up later this year. The drug could be more a cost-effective treatment in poor countries, Alton suggested. "This is really big for the developing world," he told The Wall Street Journal.

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