Is HIV combination pricing under pressure from generics?

Pricing concerns have re-emerged for Gilead Sciences (Nasdaq: GILD) and other participants in the HIV class after suggestions that United Healthcare would be offering incentives to HIV-infected individuals to use lower priced generic, or partially generic, HIV regimens, instead of Gilead and GlaxoSmithKline’s (LSE: GSK) recently introduced best-in-class combinations, comments Leerink Research analyst Geoffrey Porges.

Leerink has analyzed the list and net prices for drugs in the HIV class and finds that the viable combination treatment options are still clustered in the net price range of $2,000-$2,700/month and the price savings for payers from forcing patients through one or more of the lower priced regimens are likely to be surprisingly modest, at least at current prices.

The savings from even a two-pill solution, or an all-generic version such as Mylan’s (Nasdaq: MYL) Symfi (efavirenz, lamivudine and tenofovir disoproxil fumarate), are presently around $10,000/patient/year (33% savings).