Hepatitis C

Here are the top 5 papers published by The American Journal of Managed Care and its sister publications about hepatitis C, treatment, and costs of care.

What we're reading, November 24, 2015: expensive hepatitis C drugs are more cost effective when used earlier; clinicians aren't prescribing generics enough; and half of health 45-year-olds will develop prediabetes.

An emergency department screening and testing program based on birth cohort screening and injectable drug use found a high prevalence of the hepatitis C virus antibody among the cohorts tested, and identified several barriers to clinical implementation of the process.

A report released by the California Association of Health Plans projects a huge cost expenditure even if a small proportion of the state's hep C patients are treated with the potentially curative medications.

The arrival of Sovaldi caused pharmacy benefit managers to adjust their strategies for controlling prices for breakthrough therapies. On the eve of a new drug class for cholesterol hitting the market, Express Scripts' Dr. Steve Miller tells Evidence-Based Diabetes Management in an interview how the PBM is working on behalf of managed care in a changed environment.

On the eve of FDA's deadline for acting on the first of an expensive new class of cholesterol therapies, the chief medical officer of the nation's largest pharmacy benefit manager weighs on what steps it is taking on behalf of customers in this changing landscape.

Heterogeneity in Medicaid coverage of the anti-viral agent sofosbuvir is rampant across the United States, with varying reimbursement criteria and lack of conformation to recommendations by professional infectious disease organizations.

The company has announced that patients on Sovaldi or Harvoni who were also on the heart medication amiodarone developed abnormally slow heartbeats. This warning by Gilead could limit the drug's use.

The global price discrimination with Sovaldi has brought to light "pharmacy tourism" - patients trying to acquire the same drug at as much as 1% of the price of the drug in the US market.

The cost of treating the hepatitis C virus with newly approved therapies could total $90 billion over the next 5 years, representing 6.6% of the country's annual prescription spending.

Powerful cholesterol-fighting drugs, PCSK9 inhibitors, could break new ground for payers: a higher-priced therapy could replace generic statins for patients suffering a chronic condition, perhaps for an unspecified period of time.

Just 2 therapy classes are responsible for more than half of the increase in overall prescription drug spending in the United States, reported Express Scripts.

A year after Sovaldi's $1,000-a-pill price tag set off a national discussion, new entrants in the market to cure the hepatitis C virus have allowed pharmacy benefit managers to bring down its cost for health plans. Experts convened by The American Journal of Managed Care said this should expand who gets treatment, but they also say this won't be last of the high-cost specialty drugs.

Gilead will be providing Harvoni free of cost to conduct a 600-person trial co-sponsored by the National Institute of Allergy and Infectious Diseases to evaluate if primary care physicians and other healthcare providers, such as nurse practitioners and physician assistants, can use a new antiviral therapy as effectively as specialist physicians.

Modeling data discussed at a press conference at the 2015 Conference on Retroviruses and Opportunistic Infections showed that delaying HCV treatment, consequent to the high cost of the newer antiviral regimens, could prove fatal in patients coninfected with HIV.

Looking at the situation in hepatitis C and its potential impact on other conditions from a provider standpoint, Ed Cohen, PharmD, FAPhA, offers up many questions to which there may not be answers just yet.

The situation with hepatitis C drug costs is setting an interesting precedent for the rest of healthcare and one that needs to be watched closely, according to Keith Hoffman, PhD.

Although the marketplace has managed to come to a temporary solution for the high cost of hepatitis C drugs, Steven Miller, MD, MBA, expects to see more examples of similar high-cost drugs in other categories.

In the last year the hepatitis C drug market has gained a lot of attention in the healthcare industry despite the fact that oncology as a specialty drug market has been very expensive for years now.