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Hepatitis C drugs drive US drug costs up in 2014

Played a role in a 13% increase in US prescription spending

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The launch of new hepatitis C virus (HCV) therapies such as Gilead Sciences' Sovaldi was a key factor behind a 13% increase in US prescription drug spending last year.

The rise was the highest seen in a decade, according to pharmacy benefit manager (PBM) Express Scripts, which said the other driver for the increase was greater use of compounded medicines - those made on demand at specialist pharmacies.

Excluding compounded medicines and HCV drugs, the increase would have been around 6% last year, largely in line with historical growth rates.

The latest increase bucks a recent trend of increases below the background rate of healthcare inflation, according to Glen Stettin, a senior vice president at Express Scripts.

The PBM has become increasingly vocal about the rising cost of new prescription drugs and took matters into its own hands towards the end of last year when it gave an exclusive formulary position for AbbVie's HCV therapy Viekira Pak (ombitasvir/paritaprevir/dasabuvir/ritonavir) - at the expense of Gilead's Sovaldi (sofosbuvir) and Harvoni (sofosbuvir/ledipasvir) - in return for a discounted price. 

The move was followed by a number of similar deals and came in for criticism by some hepatologists on the grounds that restrictive formulary practices were preventing them from prescribing the medicines in clinical grounds.

Express Scripts is unrepentant, however, saying its decision will save clients more than $1bn in 2015.

"Now, more than ever, plans need to tightly manage the pharmacy benefit [and] implement smarter formularies," said Stettin.

The use of specialty medicines such as biologics and therapies for complex conditions is also rising fast and accounted for 31% of total drug spending last year. 

The new HCV therapies accounting for 45% of the increase in spend "despite having the second lowest prescription volume among the top 10 specialty conditions," said Express Scripts. Moreover, new highly priced cancer drugs and the emerging PCSK-9 inhibitor class for high cholesterol will add to the burden in future years.

The PBM recently predicted that - on their own - PCSK9 inhibitors such as Sanofi/Regeneron's alirocumab and Amgen's evolocumab could eventually cost the US healthcare system an estimated $100bn per year.

Article by
Phil Taylor

11th March 2015

From: Sales

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