Express Scripts, the pharmacy benefit manager that processes more than 1 billion prescriptions each year, is putting pressure on Gilead Sciences to lower the price of their hepatitis C drug, Sovaldi. Sovaldi is a pill that is considered to be extremely effective at treating hepatitis C, and it can cure as many as 90 percent of patients in three months. Although the drug is effective, it has caused a shock in the global medical community because of its expensive price. The cost of a three month Sovaldi treatment is currently $84,000. The cost for one pill is $1,000, and the regular course of treatment is one pill a day for 12 weeks.
Express Scripts is working to build a coalition to oppose Gilead and pressure the drug company to lower the price of the hepatitis C drug. Members of this coalition would include Express Script clients, national employers, government agencies, and health insurers. The pharmacy benefit manager hopes to convince its clients to stop using Sovaldi once a rival medicine is approved by the FDA.
Steven Miller, the CMO of Express Scripts, believes that the high price of Sovaldi would damage government run programs, such as Medicaid. “What they have done with this particular drug will break the country,” said Miller. “It will make pharmacy benefits no longer sustainable. Companies just aren’t going to be able to handle paying for this drug.”
According to Businessweek, specialty medicines — despite the fact they make up less than 1 percent of all prescriptions — account for 28 percent of the total drug spending in the U.S. Drugs treating inflammatory diseases, MS, cancer, and diabetes drugs are all responsible for high costs. Sovaldi stands to bring in an estimated $10 billion in revenue, analysts say.
Gilead has justified the expensive treatment by saying that it reduces the long term costs associated with current treatments for hepatitis C. Gilead executives have said that interferon and ribavirin injection treatments are not only long in duration, but these injections have side effects that might result in patients needing liver transplants or liver cancer treatment.