Hepatitis C and the High Cost of Treatment

The past year has been exciting hepatitis C with the introduction of drugs that have cure rates at 100%, according to clinical trials. However, these drugs have stirred up controversy because of the high costs.

Hepatitis C is a contagious liver disease that affects more than 3 million Americans. However, the Centers for Disease Control and Prevention say that most people don’t know they are infected because they don’t look or feel sick. But, people who have been infected for many years may have liver damage. Chronic hepatitis C is the leading cause of cirrhosis and liver cancer and the most common reason for liver transplantation in the US.

Hepatitis Virus C

In December 2013, the Food and Drug Administration approved Sovaldi to treat the hepatitis C virus (HCV). It was the first drug to demonstrate efficacy and safety to treat multiple types of HCV infection without the use of interferon. With nearly a 95% cure rate, Gilead Sciences put a high price on the drug: $84,000 for the full course of treatment, which comes out to $1,000 a pill.

By the end of 2014, there were 2 more HCV drugs on the market: Harvoni, also from Gilead Sciences, and Viekira Pak, from AbbVie. Harvoni is a single pill that combines Sovaldi with another medication and costs $94,500 for a 12-week full course, while Viekira Pak costs only slightly less at $83,319 for a full 12-week course.

The approval of Viekira Pak brought competition to the market. The beginning of 2015 was marked by a number of exclusivity deals with pharmacy benefit managers and health plans, which was able to drive down the cost of the treatments. Express Scripts started off the spree by negotiating a discount on the price of Viekira Pak by making it the exclusive option to treat patients with genotype 1 hepatitis C.

Although there are more drugs in the pipeline from Bristol-Myers Squibb and Merck, additional competition in the market won’t drive down prices any further, Ed Cohen, PharmD, FAPhA, senior clinical director at Walgreens, said during a panel discussion with The American Journal of Managed Care.

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