Gilead’s stealing hep C share with its cut-rate Eplusa and Harvoni generics

Last September, Gilead made the unexpected move of launching authorized generics to its blockbuster hepatitis C drugs Epclusa and Harvoni, well before their patients expire. Now the copycats have grabbed a hefty chunk of the market—and not only at the expense of Gilead brands.

Officially launched early this year via Gilead’s subsidiary Asegua Therapeutics, generic Epclusa has snared 19.5% of the total U.S. hepatitis C market. Generic Harvoni makes up 2.1%, J.P. Morgan analysts noted Friday based on the most recent IQVIA prescription data.

AbbVie’s Mavyret, which shook up the HCV scene after its August 2017 launch, thanks to a shorter eight-week treatment course and lower price tag, is apparently losing some ground to the Gilead generics, but still leads the category with a share of 41.0%

Gilead marked its generics with a $24,000 list price, slightly lower than Mavyret’s $26,400—which is itself a huge discount from Epclusa’s $74,760 sticker. Both Epclusa and Mavyret can treat all six major genotypes of HCV.

Long gone are the days of megablockbuster HCV sales, with existing patients cured and fierce competition driving down net prices. But Gilead has been counting on the lower-priced copycats to pump up sales by winning a bigger share of patients—after all, the lower sticker price means lower copays at the pharmacy.

One way Gilead's doing that is through state-managed Medicaid plans. When Gilead first unveiled the generics initiative, Evercore ISI analyst Umer Raffat noted the company’s presence in Medicaid was very low, as Mavyret takes the lion’s share.

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“We expect to see a positive impact on sharing Medicaid markets during the second half of 2019. Over the long-term we anticipate the adoption of these authorized generics will allow us to be more competitive in a rapidly growing Medicaid segment,” Laura Hamill, Gilead’s EVP of worldwide commercial operations, said during a conference call in February.

In the second quarter, the generics accounted for more than 25% of Gilead’s U.S. hep C revenues of $355 million, which was down 35% year over year, CFO Robin Washington told investors on the Q2 earnings call in July. The company was “very encouraged” by the copycats’ performance and was hoping they could “continue to improve our HCV competitive positioning.”

Fast forward to the third quarter, and now, the Epclusa generic’s total prescription numbers have jumped 77.7% in the quarter to date, though the Harvoni copycat dropped 9.9%, according to J.P. Morgan’s report. The AbbVie drug’s scripts suffered a 16.3% loss so far in Q3, as branded Harvoni and Epclusa decreased 24.9% and 7.5%, respectively.