France strikes big hep C treatment deal for Gilead's Sovaldi

Gilead's Sovaldi

France threatened to tax hepatitis C drugmakers if they insisted on charging nosebleed prices. Apparently, the arm-twisting worked: The French government says it has cut a deal with Gilead Sciences ($GILD) to get Sovaldi at the lowest price in Europe.

Plus, the price goes down if volume hits certain targets. And if treatment doesn't work, France will get money back. In return, France agreed to fund hep C drugs at 100%--no copays to scare patients away.

The quoted price per box of Gilead's hep C wonder drug will be €13,667 in France, the government's Health Ministry said Thursday. That's €5,000 less than its original price in the country. And it puts a 12-week course of treatment at €41,000, or about $51,000.

France estimates 200,000 cases of hep C within its borders, and the cost of treating all of them worries government officials, just as it does payers in the U.S. Given the number of patients, Gilead agreed to "additional reductions related to the volumes of sales forecasts," the Ministry said in its statement. A pay-for-performance clause specifies rebates in case of treatment failure.

That's compared with €56,000 for a 12-week course before the negotiated deal, or about $70,000. And in the U.S., that 12-week treatment price--at least the publicly quoted one--is $84,000.

Despite that price, which spooked payers into finding new ways to limit their spending, Sovaldi raced to blockbuster status in the U.S., and is on track to top $10 billion in sales this year. In Europe, where roll-outs depend on country-by-country reimbursement approvals, the growth has been much slower. And with European prices tracking much lower, the slower rate of growth is bound to continue.

In the U.K., the famously skeptical cost-effectiveness watchdogs at the National Institute for Health and Care Excellence recently backed Sovaldi for routine use by the NHS--and the National Health Service quickly determined behind closed doors that the system couldn't afford to treat the many hep C patients who'd be eligible. After all, Sovaldi is just one in a cocktail of several drugs needed to arrest the disease, albeit the most expensive one.

Meanwhile, on Wednesday, European regulators gave Gilead the thumbs up for its Sovaldi combo treatment, Harvoni, which pairs the active ingredient in Sovaldi, sofosbuvir, with a new antiviral, ledipasvir.

In the U.S., that combo med--which can be given solo to many hep C patients, and with the add-on of an older antiviral for others--costs $94,500. According to Reuters, Harvoni has temporary approval for sale in France at €16,000 per box, which works out to €48,000 for a 12-week course, or about $60,000. Negotiations for a long-term deal are underway.

- see the release from the French Health Ministry
- read the Reuters news

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