Gilead price lambasted by US health insurers
pharmafile | May 21, 2014 | News story | Medical Communications, Sales and Marketing | Gilead, Incivek, Victrelis, hepatitis C, sovaldi
Gilead’s new hepatitis C pill Sovaldi is coming under more pressure in the US as health insurers hit out at its high cost.
Sovaldi (sofosbuvir) costs $1,000 a day, or around $84,000 per course of treatment per patient, making it one of the most expensive medicines on the market outside of oncology or rare disease.
And this has proved too much for the leading US health insurer AHIP (America’s Health Insurance Plans), which has hit out at Gilead’s new treatment, accusing pharma of taking advantage of the insurance system by pricing products at unsustainable levels.
“Sovaldi has shown tremendous results, and it’s the kind of medical innovation we need to sustain. Unfortunately, the drug’s maker has priced it at an astronomical level that is not sustainable for consumers, innovation, or society,” AHIP says on its Coverage blog.
But as the AHIP admits, the drug is highly efficacious and can effectively cure the disease in over 90% of patients in 12 weeks. This is compared to other treatments such as Vertex’ Incivek (telaprevir) and Merck’s Victrelis (boceprevir), which take double the amount of time to treat and have cure rates of around 75 per cent.
This efficacy has also translated into astonishing sales – hitting over $2 billion in its first quarter – making it the fastest-selling medicine in the world and on course to break the $10 billion barrier by next year, should this trajectory hold.
Cara Miller, a spokeswoman for Gilead, defended the drug’s pricing, saying: “While Sovaldi greatly enhances the standard of care for hepatitis C, it was priced such that the total regimen cost is equal to that of prior standard of care regimens.
“Sovaldi reduces total treatment costs for HCV – taking into account the cost of medications (including those for side effects or complications) and healthcare visits – and it represents a finite cure, an important point to consider when comparing the price of a pill or bottle to the lifetime costs of treating a chronic disease.”
Safety profile
The drug also appears to have a strong safety profile. AdverseEvents, a company that specialises in analysing FDA side effect reports for payers and healthcare providers, put Sovaldi at the top of the pile in a recent review of hep C drugs.
Most of the adverse events were mild, according to the firm, and Sovaldi earned an ‘Rx Score’ – a measurement on a 100-point scale – of 15.36.
This is compared to the next-safest hep C drug, which is according to AdverseEvents Victrelis, with a score of about 27. On average, the hep C treatments studied carried an Rx Score of more than 45.
AdverseEvents adds that whilst expensive, Sovaldi has a high cure rate, and its use will save money in the long run by reducing the need for liver transplants. “Despite the high price, we saw no evidence from a safety perspective to recommend an alternative treatment should be covered by providers at this stage,” the report concludes.
And other payers seem to be having the same thought process. In March the NHS England established a unique £18.7 million fund to pay for the drug, which was recently approved in the UK, before it has been appraised by NICE.
Ben Adams
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