Express Scripts says drugs for conditions like rheumatoid arthritis, MS, cancer and in particular hepatitis C are pushing costs to unsustainable levels. The so-called specialty drugs account for about 1% of US prescriptions but accounted for 27.7% of the pharma spend in 2013. Hepatitis drugs have been singled out (Gilead's Solvaldi is new) as a 12 week course costs $84,000. Plus, hepatiis C drugs apply to a large patient population.
The Express Scripts analysis says drugs like Sovaldi will drive specialty prices by 63% over 2014-2016 period. Analysts project that Solvaldi could rack up $10 B in revenues in 2014 alone. Express Scripts says that the US will spend 1800% more on hepatitis C drugs in 2016 than now --- an unprecedented hike.
Express Scripts chief medical officer, Steve Miller, said that "never before has a drug been priced so high to treat a patient population this large, and the resulting costs will be unsustainable for our country" (cue Star Spangled Banner). Gilead for its part says the drug's extraordinary cure rate is worth it and saves money to healthcare overall.
I think Gilead has its point but the sticker shock of the new drugs is a big issue. Express Scripts isn't the only one making noise. WHO also said today that it thought hepatitis C pricing was out of hand and other emerging governments have voiced complaints as well --- particularly with regard to low income patient access issues. This is not the type of issue that will go away quietly. See the PharmaTimes and Bloomberg.
Posted by Bruce Lehr April 9th 2014.