The ongoing war over drug prices has spawned numerous cost-saving initiatives from payers and the federal government, and now a new program from UnitedHealthcare has Gilead Sciences feeling the hurt.
Unveiled this week, UnitedHealthcare’s MyScriptRewards program will offer patients up to $500 in prepaid debit cards for medical expenses if they work with their doctors to choose lower-cost HIV drug regimens. The program is rolling out in HIV antivirals to start, with other specialty drug classes to follow.
Even though the insurer unveiled its program on Monday, the news was enough to scare Gilead Sciences investors on Wednesday. Shares sank 6%, MarketWatch notes. Gilead shares rebounded a little Thursday, climbing about 1.5% in morning trading.
The new program—which puts GSK and Merck drugs ahead of Gilead's in the cost-effectiveness parade—comes as Gilead's hepatitis C franchise remains in steep decline, making the company more dependent on growth in its HIV business and its newly launched CAR-T drug Yescarta. The third quarter did produce a glimmer of hope—particularly in HIV—but analysts remain skeptical that Gilead can keep up the pace.
After getting an initial prescription for a lower-cost HIV drug option, patients are eligible for the first debit card of $250. If they continue using the cheaper regimen for six months, they can get a second $250 prepaid card.
UnitedHealthcare said regimens using Mylan's Cimduo and GlaxoSmithKline's Tivicay—or Cimduo and Merck's Isentress—are the "most cost-effective" treatments available through its formulary. Eligible patients can obtain them at no out-of-pocket cost.
The rollout comes amid a yearslong war between payers and pharma over climbing drug prices. And the Trump administration has stepped in lately, with plans to force lower Medicare Part B drug prices, among other objectives. The FDA is also approving a record number of generic drugs in another effort to lower costs, and HHS is pushing for drug prices in TV ads.