Hepatitis C Virus Drug Costs Likely to Fall

Proposals such as allowing Medicare price negotiation, capping out-of-pocket drug costs, importing drugs, and limiting manufacturer’ spending on patient marketing could all result in lower HCV drug costs, the authors wrote.

Competition has also been seen to impact HCV drug pricing, and will likely continue to do so in the future as more drugs receive regulatory approval.

The FDA’s approval of Viekira Pak (ombitasvir, paritaprevir, and ritonavir tablets; dasabuvir tablets) in 2014 impacted the pricing of Harvoni. The new approval elicited support from Express Scripts, who then dropped Harvoni and sofosbuvir for patients with HCV genotype 1.

This resulted in Gilead’s stocks taking a 20% hit, prompting them to offer discounts for Harvoni to certain payers. If manufacturers take similar actions, drug costs may be reduced even further.

The most recent approval of Merck’s Zepatier (elbasvir and grazoprevir) caused waves for many reasons. First, the drug’s cure rate was 97% to 100% in patients with HCV genotype 4, and 94% to 97% in patients with genotype 1, which is higher compared with other drugs.

Notably, the price for the drug was only $54,600 for 12-weeks of treatment, which improves access to affordable drugs, according to the report.

A pipeline drug, odalasvir, being developed by Achillion Pharmaceuticals and Johnson & Johnson, also has the potential to reduce drug costs. The drug has shown a 100% cure rate in as little as 6 weeks in combination with sofosbuvir. Shorter treatment spans will likely result in less costly drugs, the authors noted.

Despite treatment for HCV being medically necessary, payers still do not think the high costs for the drugs warrant widespread treatment. However, critics may counter that in the long run, payers are costing themselves more money.

Patients who do not receive treatment for HCV are more likely to develop liver cancer and type 2 diabetes, experience plaque build-up in the arteries, and have an increased risk of stroke, according to the report.

While Gilead’s drugs remain some of the highest priced on the market, the entrance of new, lower cost drugs will likely drive down the cost of HCV treatment over time.
Until that happens, specialty pharmacies and their pharmacists should focus on directing patients to copay assistance programs, and help patients adhere to treatments, the report concluded. 

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