Continued Scrutiny Over Sovaldi, Other HCV Treatment Costs

Published Online: August 05, 2014
Katie Sullivan, MA
A new report suggests that the cost of hepatitis C drugs —including Gilead Sciences Inc.’s $1,000-a-day treatment Sovaldi—will increase federal spending for Medicare Part D as much as $3 to $6 billion in 2015.

The Pharmaceutical Care Management Association, the consulting firm that conducted the analysis, said that the cost of HCV drugs would also increase the total annual individual Medicare Part D premiums to $965 million in 2015, nearly double the $481 million that is currently paid.

“We estimate that the cost of new HCV drug therapies, including Sovaldi and Olysio, will increase 2015 federal spending on the individual Medicare Part D program by approximately $2.9 billion to $5.8 billion,” read the report. “This is equivalent to a 6% to 11% increase in federal Part D spending or approximately $100 to $200 per Medicare Part D beneficiary per year.”

The report noted that as many as 3.2 million Americans are infected with hepatitis C, though many may currently be undiagnosed. Among those infected, an estimated 270,000 received Medicare Part D benefits in 2013. The costs of treating this population, particularly with pricey treatments like Sovaldi, is projected have a significant impact on Medicare Part D spending.

“Never before has a drug been priced this high to treat a patient population this large, and the resulting costs will be unsustainable for our country,” said Express Scripts chief medical officer Steve Miller of Sovaldi.  “The burden will fall upon individual patients, state and federal governments, and payers, who will have to balance access and affordability in way they never have had to before.”

Around the Web

The Impact of New Hepatitis C Drug Therapy on Individual Medicare Part D Spending [Milliman]

‘Unsustainable for Our Country’: Express Scripts Calls Out Pricey Meds [The Wall Street Journal]