The race is on for the company that can competitively price treatment regimens, share data on clinical benefit/positioning and support patient initiatives.
Payer Insights: Hepatitis C, based on in-depth interviews with 12 leading healthcare payers in the US, is packed with hard-hitting, candid opinions and advice on how, from their perspective, Pharma can get it right in the future.
Gilead’s commercial success with its ground breaking HCV treatment Solvadi has been matched by the opposition of healthcare payers at the cost.
This report gives insights into what US healthcare payers really think about HCV drug pricing, the growing and frighteningly undefined patient population, limited clinical/outcomes data, poor patient adherence and education - and how can industry positively help and respond.
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“Someone needs to look at real world data and state what's really working, what's the most cost-effective treatment, because even for genotype 3 patients, peginterferon and ribavirin are still preferred versus adding Sovaldi, but that hasn't come across [and] everybody's just automatically adding it. You're looking at going from ,000 with a 48 week course to 2,000, 3,000 for a 12 week course. So it's really hard to justify some of this.”
“What's changed is not solely a function of hepatitis C. It's been influenced by specialty drugs as a whole, and the realisation that if plans didn't have a specialty tier on their drug benefit, they now should. Sovaldi, snuck up on everybody with its pricing… everybody was thinking of Sovaldi as being just a follow on to Incivek and Victrelis. While they were not inexpensive either, Sovaldi took it to another level. Most plans have put in place prior authorisation criteria that allow for its use.”
“There's a lot of scepticism [and] disbelief or distrust with Gilead and whoever's going to come out next, depending upon what their launch looks like and what their cost is. There's a lot of frustration with the Federal Government in allowing things like this to happen. So I think the next six months are going to be really difficult for the manufacturers. If they come in 20 percent less than what Gilead did and the product is all oral or has a better safety profile, better adherence, better efficacy, I think that they will definitely easily take the market over.”
Table of Contents
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