A Major Shift in the Price War for Hep C Drugs

By John Lavitt 01/06/15

The AbbVie deal with Express Scripts could mark the end of the $1,000 a pill treatment for hepatitis C and the beginning of more affordable care for the disease.


After months of controversy over the high cost of new hepatitis C treatment drugs, pharmaceutical company AbbVie has signed a discount deal with Express Scripts that represents a major shift in the price wars. One step ahead of their competition, Gilead Sciences managed to corner the HCV treatment market for the past year with the ultra expensive new drugs Sovaldi and Harvoni. With the FDA approval of AbbVie’s Viekira Pak and the resulting discount deal with Express Scripts, the shifting down of the price landscape has begun.

A national pharmacy benefit manager, Express Scripts announced the successful negotiation of a significant discount deal with AbbVie. In exchange for the discount, Express Scripts will make Viekira Pak the exclusive option for 25 million people. Previously, the Gilead drugs had been by far the most effective option for people infected with the hepatitis C virus. 

Despite curing the vast majority of patients in only 12 weeks with few side effects, the staggeringly high prices led to a firestorm of negativity. With a list price of $84,000 for a 12-week course, Sovaldi became known as the $1,000 per day pill. For 12 weeks, Harvoni cost even more, coming out at a total of $94,500.

In even bigger news for HCV patients that could break the back of treatment limitations brought on by the high costs, Express Scripts said it would allow all people with hepatitis C to be treated with AbbVie’s drug. Before, in the face of the high costs, only patients with more serious liver damage were being given access to treatment. As the chief medical officer of Express Scripts, Dr. Steve Miller explained this change in policy, “We really believe we want all patients treated.” 

Beyond Express Scripts, a majority of health plans, state Medicaid programs and prison systems simply could not afford to offer widespread treatments in the face of the huge prices. As a result, HCV treatment was being limited to only the sickest patients. Dr. Miller had publicly referred to himself as the “chief whining officer” in light of his ongoing complaints about the high Gilead prices. The new discount deal for Viekira Pak will help hold down health care costs for employers that use Express Scripts. 

Still, Viekira Pak is approved only for so-called genotype 1 hepatitis C. Although genotype 1 accounts for close to 75% of HCV cases in the United States, many thousands of people with the virus have other genotypes. Recognizing this problem, Express Scripts said it would still pay for Sovaldi in the treatment of people with the other genotypes. 

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Growing up in Manhattan as a stutterer, John Lavitt discovered that writing was the best way to express himself when the words would not come. After graduating with honors from Brown University, he lived on the Greek island of Patmos, studying with his mentor, the late American poet Robert Lax. As a writer, John’s published work includes three articles in Chicken Soup For The Soul volumes and poems in multiple poetry journals and compilations. Active in recovery, John has been the Treatment Professional News Editor for The Fix. Since 2015, he has published over 500 articles on the addiction and recovery news website. Today, he lives in Los Angeles, trying his best to be happy and creative. Find John on Facebook, Twitter, and LinkedIn.