Express Scripts says AbbVie's Viekira Pak to be exclusive option for genotype 1 hepatitis C

Offering what it says is an unprecedented solution to an unprecedented health care challenge, Express Scripts (Nasdaq: ESRX), the USA’s largest pharmaceutical benefits management firm, today announced an update to its National Preferred Formulary that will significantly expand access to AbbVie's (NYSE: ABBV) newly-approved Viekira Pak, a breakthrough treatment for hepatitis C.

Viekira Pak (ombitasvir, paritaprevir and ritonavir tablets co-packaged with dasabuvir tablets), approved last Friday by the US Food and Drug Administration (The Pharma Letter December 20), was determined to be at least clinically equivalent to Gilead Sciences’ (Nasdaq: GILD) Harvoni (ledipasvir and sofosbuvir) and Sovaldi (sofosbuvir) by Express Scripts' independent Pharmacy & Therapeutics Committee. As a result of the committee's determination, Viekira Pak will immediately be added to the Express Scripts formulary, and will be the exclusive option for patients with genotype 1 hepatitis C, regardless of symptoms or disease progression, starting January 1, 2015.

According to a Reuters report, Express Scripts declined to say how much it would pay for the AbbVie drug, which it will sell only through its by-mail Accredo specialty pharmacy. Its official price is $83,319 for a 12-week treatment and is also indicated for a 24-week treatment for some patients. Drug makers typically discount drugs in the USA by 10% to 20%, according to Reuters. Sovaldi’s US list price is $84,000 12 weeks’ therapy.

Price to Express Scripts likely to be similar to that in Europe

Express Scripts chief medical officer Steve Miller said in an interview that the AbbVie price was narrowing the gap towards the lower prices that Western European countries have negotiated for their citizens for Sovaldi. They run from $51,373 in France to $66,000 in Germany.

About 75% of the more than 3 million Americans with hepatitis C have a form of the virus known as genotype 1. All clinically appropriate patients with that form of hepatitis C who are covered by the Express Scripts NPF - which covers about 25 million Americans - will have access to Viekira Pak.

Beginning January 1, 2015, Sovaldi, Harvoni and Olysio (simeprevir) will be excluded from the NPF. Sovaldi, Harvoni and Olysio will continue to be available for patients who have already begun treatment regimens. Sovaldi will be available for patients with other hepatitis C genotypes who have advanced liver disease. As a result of the news, Gilead's shares plunged 13% to $93.68 by mid-day on Monday.

"Express Scripts and AbbVie have a single focus: do what's right for hepatitis C patients," said Dr Miller, adding: "For the first time, a pharmaceutical manufacturer and a pharmacy benefit manager have created an agreement to deliver on the promise of a curative therapy for hepatitis C patients. Pharmaceutical innovation must be rewarded based on the value it brings to patients and payers. This agreement marks a fundamental change in how sustainable access and affordability will be delivered to hepatitis C patients."