Close on the heels of Express Scripts’ decision to make AbbVie’s Viekira the exclusive hepatitis C treatment in its formulary, CVS Health said it would make Gilead Sciences’ Harvoni and Sovaldi the exclusive option for patients on its commercial drug list, as well as those on Medicare Part D and Medicaid.
Close on the heels of Express Scripts’ decision to make AbbVie’s Viekira Pak the exclusive hepatitis C treatment in its formulary, CVS Health said it would make Gilead Sciences’ Harvoni and Sovaldi the exclusive option for patients on its commercial drug list, as well as those on Medicare Part D and Medicaid.
“The high price of these new hepatitis C treatments and the expanding pool of patients receiving treatment signal a growing and costly trend in treating chronic medical conditions with specialty medicines,” said Troyen A. Brennan, MD, chief medical officer of CVS Health, in a previous CVS statement. “Hepatitis C is just the beginning, and we need to prepare now for the time when large numbers of patients could be treated effectively with high-cost medicines for a variety of common and more complex conditions.”
In mid-December, CVS Health released research showing that there has been minimal reduction in Solvadi use since the launch of Harvoni in October, “suggesting an expansion in the pool of patients being treated, rather than Harvoni being used as a substitute for Sovaldi”, according to the CVS Health statement
CVS Health’s research also revealed that uptake for Harvoni prescribing is approximately 2.5 times higher than the rate of Sovaldi prescribing was during the first weeks after its launch in December, 2013.
CVS Health’s commitment to Gilead’s Hepatitis C drugs pushed Gilead’s shares 2% higher in Monday trading, while AbbVie’s shares fell 2%. Conversely, after Express Scripts’ December announcement, there was a steep drop in Gilead’s shares and in many other biotech stocks.
Still, both CVS Health and Express Scripts’ decisions are short-sighted and premature, according to Robert Taketomo, president and CEO, Ventegra, a managed care contracting services organization.
“Fundamental issues that need to be addressed for these decisions that impact patients, providers and payers-those, not the PBM, who are actually paying the bill for these drugs-include the development of more sophisticated patient treatment criteria-since the majority of hepatitis C patients do not succumb to this disease-proof of therapeutic interchangeability based upon medical evidence to justify selective positioning, and programs to prevent re-infection [and retreatment],” Taketomo told FormularyWatch. “Otherwise, these tactics could drive utilization of very expensive agents which may not be clinically and financially appropriate.”