Express Scripts says AbbVie drug could displace Sovaldi on formulary

Last Updated: 2014-10-29

By Ransdell Pierson

(Reuters) - Pharmacy benefit manager Express Scripts Holding Co said it may quickly change its preferred drug formulary to favor an expected new hepatitis C drug from AbbVie if it is clinically equivalent and less costly than Gilead Science Inc's $84,000 Sovaldi and $94,500 Harvoni treatments.

Sovaldi (sofosbuvir), with its price tag of $1,000 a pill, has become a lightning rod in a debate over the high cost of specialty drugs, despite its cure rate of more than 90% and gentle side effect profile.

"The cost of it is unsustainable for many of our plans," Steve Miller, chief medical officer of Express Scripts, told analysts on a conference call on Wednesday, referring to Sovaldi. The drug had third quarter sales of $2.8 billion even though it was only approved in December.

Harvoni, approved this month by U.S. regulators, combines sofosbuvir with ledipasvir (also from Gilead) and is expected to dominate treatment of the liver disease that affects an estimated 3 million Americans.

Miller said Sovaldi's cost is particularly hitting state prisons and Medicaid, the insurance program for the indigent funded jointly by states and the federal government, because those populations have high rates of infection with the hepatitis C virus.

Express Scripts said U.S. regulators by December could approve AbbVie's product, which combines three drugs into a single pill.

"(We) are hoping they take a different approach when it comes to pricing," Miller said.

But Adelle Infante, an AbbVie spokeswoman, said no price has been disclosed for her company's drug, which does not yet have a name. The suburban Chicago drugmaker is hoping it will be approved this year.

Gilead officials could not immediately be reached for comment.

The AbbVie product, like Harvoni, would not need to be taken with interferon, a harsh injectable drug that for years had been part of a standard regimen for the disease, which can quietly harm or destroy the liver over a period of decades.

Should the AbbVie drug be deemed clinically equivalent but less costly than Sovaldi and Harvoni, Express Scripts spokesman Brian Henry said the Gilead drugs could be given lower priority on its drug formulary, or be removed from it.

Express Scripts is the largest U.S. pharmacy benefit manager. It administers drug benefits for employers and health plans and also runs large mail order pharmacies.