Bristol-Myers' 91-country hep C access plan still draws fire from price critics

Bristol-Myers Squibb ($BMY) is taking Gilead's ($GILD) lead when it comes to developing-world access for its hepatitis C drug, offering up a tiered pricing strategy and licensing agreements with generics makers. But according to some critics, that's not enough.

The company has kicked off discussions with government health authorities in several countries to facilitate access to Daklinza (daclatasvir), taking into consideration factors like their economic development, burden of disease, and government commitment to hep C treatment and care when ironing out costs through its tiered pricing model, it said. It also plans to work with generics manufacturers to supply licensed copies to 90 countries around the world, including India, Cuba, South Africa and Vietnam.

"We are eager to leverage our considerable experience in developing world access to our HIV medicines in order to bring daclatasvir to the developing world as soon as possible," Bristol-Myers said on its website.

The move follows a similar strategy announced by Gilead--whose pricey Sovaldi, at $84,000 per 12-week treatment course, has drawn ire since its approval late last year--in September. The California biotech has joined up with generics pros like Mylan ($MYL) and Ranbaxy to bring cheap versions to 91 developing countries.

But according to outspoken access advocate Médecins Sans Frontières, BMS' plan won't get the job done. Rohit Malpani, the director of policy and analysis for the group's access campaign, didn't hold back, accusing the pharma giant of "intentionally" blocking affordable access to Daklinza from most middle-income countries, "with BMS keen to extract as much profit as it possibly can."

"Once again, people in middle-income countries--where nearly three-quarters of the world's poor, and over 70 percent of people with hepatitis C, live--are the ones left empty-handed," he said in a statement.

Pricing for the new crop of hep C drugs has come under fire at home, too. Payers have had to get creative to contain soaring costs, with Express Scripts ($ESRX) going as far as beginning to assemble a coalition to exclude Sovaldi from formularies until lower-priced rivals hit the market and force prices down.

On that front, the PBM's CMO, Steve Miller, last week told Reuters Express Scripts was ready to favor a competitor from AbbVie ($ABBV) once it won FDA approval and hit the market, assuming it was clinically equivalent--and, of course, less expensive.

- read Bristol-Myers' release
- see MSF's release

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