As oral hepatitis C market grows, will AbbVie use a radical pricing strategy?
- AbbVie's oral triple-drug medication, which only requires 12 weeks of treatment, may be approved for the treatment of hepatitis C in the near future.
- Experts are predicting lower price points for AbbVie's new drug, compared with Gilead's Sovaldi.
- Although the new hep C combo has comparable efficacy with Sovaldi, a more complex dosing regimen and tolerability issues make it more challenging for patients.
Approval of AbbVie's triple-drug combo for hepatitis C (HCV) may be imminent. Assuming this happens, there will be a major shift in the market. Gilead's Sovaldi will not be the only oral, interferon-free treatment option for HCV. However, while both drugs only require 12-week treatment regimens and have sustained viral reduction rates that hover at the 99% level, AbbVie's drug requires multiple pills a day and comes with unpleasant potential side effects, such as fatigue, nausea, itching and weakness.
Seems like an easy call, but it's not. No one knows exactly how pricing will play out, but a logical strategy for AbbVie would be to price its drug lower---how much lower no one knows. With all the uproar over Sovaldi's $84,000 price tag, many payers will consider AbbVie's drug a desirable, if imperfect, alternative. The big question is whether patients treated with the new triple-drug combo will adhere to the 12-week regimen in order to effectively be 'cured' and avoid problems later on.
There are very few HCV adherence studies, but there are some data available. A study published in the Annals of Pharmacotherapy in 2007 (2007;41:11-23.) tracked adherence among a group of HCV-infected individuals treated with the standard regimen at that time--a 48-week regimen that included interferon. Not surprisingly, adherence decreased over time.
The advantage of both treatment options--- Sovaldi and the triple-drug combo---is that they are 12 weeks. This could work in AbbVie's favor. Even when patients were dealing with a more difficult course of treatment, adherence levels at 12 weeks were still 85%. Some payers may consider this a suitable trade-off, given the relatively short treatment period. The idea would be: "It's not ideal, but it's an oral, interferon-free regimen---and it's affordable and reimbursable. Deal with it for 12 weeks."
At this point, the ball is in the regulators' court--though soon the payers will be calling the shots.
- www.chicagobusiness.com Why AbbVie needs to rethink the price of its hepatitis C drug
- www.bloomberg.com AbbVie Hepatitis C Combo Cures Almost All in Late Study
- Annals of Pharmacotherapy Assessing the validity of self-reported medication adherence in hepatitis C treatment.