- Express Scripts SVP Dr. Steve Miller published a letter on the company website linking the firm's negotiations with AbbVie for a discount on hep C treatment Viekira Pak with an overall shift in national costs, citing a total of $4 billion in U.S. healthcare savings as a result.
- Dr. Miller noted the introduction of Gilead's Sovaldi and Harvoni and AbbVie's Viekira Pak as true game-changers that were initially priced at levels that would only allow the sickest patients to gain access to them.
- Dr. Miller also explained that AbbVie shared Express Scripts' view that pricing should be fair--and the end results was placement of VieKira on the formulary in an exclusive position, resulting in the ability to provide hepatitis C treatment to all patients in need of treatment.
While the letter from Dr. Miller to interested stakeholders may seem like another piece of marketing or good public relations—and it is both—it holds kernels of truth. It's possible that each successful negotiation between an insurer or benefits manager and Gilead/AbbVie exerts overall downward pricing pressure while boosting access—what Dr. Miller calls a "ripple effect."
The net effect of this type of acknowledgement is not only the ability of other payers to leverage their power to get lower prices for hep C treatments, but also the ability of payers to leverage their power more aggressively across the board of pricey therapeutic classes.
What's less clear is how the numbers add up, particularly the "$4 billion savings" claim. Pricing discussions between payers and Gilead and AbbVie have been relatively hush-hush, and although reports have implied discounts of 20% to 30%, we still don't know just what the pricing levels are (and how much of the savings are being passed on from payers to patients).