Gilead’s Hepatitis C drugs Sovaldi and Harvoni are often targeted for their upfront price, rather than their long-term benefits for patients. Some states are pushing for legislation which would require drug companies associated with the drug, often citing Sovaldi’s $84,000 course of treatment as a core reason behind the push. Massachusetts has proposed mandatory price caps in certain cases.
However, what is often lost in the discussion is the fact that Hepatitis C is the leading cause of cirrhosis, liver cancer, and liver transplantation. These diseases and surrounding procedures and complications are not only painful for patients, but extremely costly—potentially hundreds of thousands of dollars. Medical costs associated with liver disease can be lifelong expenses. The new Hepatitis C drugs cure as many as 90 percent of patients with Hep C. Furthermore, there are fewer complications and side effects than existing treatments, allowing recipients to lead better lives.
A recent Bloomberg story featured a report from an influential panel of doctors and medical experts who found the treatments were indeed “cost effective.” The report is from a 32-member panel representing more than 10,000 physicians, health workers and scientists “that helps insurers set policies.” The HCV Guidelines panel is a joint effort by the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America. Its recommendations, which haven’t previously included cost-effectiveness language, will give doctors backing to argue that insurers should make the drugs more widely available, states the Bloomberg article. The article quotes one member of the group, a doctor from Boston Medical Center, as saying that the answer to whether these drugs are cost-effective is “a resounding yes.”
“Health insurers that have been reluctant to cover hepatitis C drugs…will face more pressure after a report concluding the medications are ‘cost-effective’ given their benefits,” the author writes. The article also notes that the “catalog price” is often not what is listed in reports. “Health insurers and government programs have negotiated discounts of almost half of Gilead’s list price, on average, the company has said.”
Open Payments Used To Show Guideline-Makers Financial Ties
“Because the hepatitis C panel includes some of the top researchers in the field, many of its members have financial ties to the drugmakers,” states the Bloomberg article. “At least 18 of the 32 panelists received more than $1,000 in payments or funding last year from either Gilead or AbbVie, according to disclosures on the guideline website and data published last week from the U.S. Centers for Medicare & Medicaid Services.”
The article notes that “[o]nly eight received no funding or other compensation, such as meals.” One of the doctors on the panel who provided his input to the Bloomberg article is noted as receiving “about $125 in meals from drugmakers” during 2014–a figure taken from the Open Payments database.
PhRMA has provided additional information on the pricing of cures in recent posts.
What They Are Saying about New Hep C Cure: “That’s actually a great deal”
ICYMI: Insurer: “Can drugs as expensive as these really be cost-effective? The answer is yes.”