WOONSOCKET, R.I. — An analysis by the CVS Health Research Institute shows a rapid uptake of two new hepatitis C medications and illustrates the cost implications of effective treatment with specialty drugs.
CVS said Thursday that the research study found an increase in the number of eligible hepatitis C patients being treated after the October launch of Harvoni (ledipasvir and sofosbuvir), the latest hepatitis C treatment. Uptake for Harvoni is about 2.5 times that of Sovaldi (sofosbuvir) prescribing during the weeks following Sovaldi’s launch in December 2013.
In addition, the CVS/caremark data shows there has been minimal reduction in Sovaldi use since the launch of Harvoni, indicating an expansion in the pool of patients being treated, rather than Harvoni being used as a substitute for Sovaldi.
Harvoni costs about $1,125 per pill and $94,500 for a 12-week course of therapy, while Sovaldi costs $1,000 per pill and $84,000 for 12 weeks of treatment.
"The high price of these new hepatitis C treatments and the expanding pool of patients receiving treatment signal a growing and costly trend in treating chronic medical conditions with specialty medicines," study co-author Troy Brennan, chief medical officer for CVS Health, said in a statement. "Hepatitis C is just the beginning, and we need to prepare now for the time when large numbers of patients could be treated effectively with high-cost medicines for a variety of common and more complex conditions."
Considering the impact of expensive specialty drugs on payers’ budgets, CVS/caremark and the company’s specialty pharmacy have instituted an array of tools to manage cost while ensuring patient health outcomes. For hepatitis C therapy, CVS/caremark coordinates utilization management and prior authorization strategies to drive evidence-based decision-making. The tools help identify patients who will best respond to therapy to optimize efficacy and reduce unnecessary costs.
Also, CVS said, thoughtful formulary placement plays a key role. As new and equally effective treatments from other manufacturers are expected to enter the market soon, aggressive negotiation on price and the development of formulary tiers or exclusions can help manage costs for payers, the company noted.
"As new therapies enter the market, particularly in categories such as hepatitis C where treatment costs are high, CVS Health is focusing on strategies to control costs while improving patient health outcomes," stated Alan Lotvin, executive vice president of CVS/specialty at CVS Health. "These will include utilization management and formulary approaches to ensure the most cost-effective, clinically appropriate therapy. We also provide comprehensive, patient-centered support to maximize the successful completion of therapy."
