Aetna Inc, the third-largest U.S. health insurer, said it negotiated a discount with Gilead Sciences Inc for its hepatitis C treatment and will offer it as the preferred choice to nearly 11 million commercial customers.
Aetna, which posted an updated coverage policy on its website on Friday, said it believes the price it received for Gilead’s Sovaldi, and a newer combination treatment called Harvoni, is “competitive with other recently announced agreements for this class of therapy.” It would not detail the size of the discount.
Gilead shares closed up 3.4 percent at $100.71 after the Aetna deal was announced. Aetna shares closed 2.3 percent higher at $92.56.
Aetna and other insurers have pushed back against the high price of new hepatitis C treatments and other drugs, questioning their affordability after Gilead’s Sovaldi was priced at $84,000 per treatment when it became the first new all-oral treatment to reach the market in late 2013.
U.S. health regulators late last month approved Viekira Pak from AbbVie Inc, the first competitor to Gilead’s drugs. Within a few days, Express Scripts, the largest U.S. pharmacy benefits manager, dropped coverage of Gilead’s treatments in most cases in favor of the AbbVie therapy, citing a substantial discount.
Both breakthrough treatments for the first time can cure the liver-wasting disease in more than 90 percent of patients without the miserable side effects of older medicines. More than 3 million people in the United States are estimated to have hepatitis C.
Since Express Scripts’ move, insurers have pressed both AbbVie and Gilead for discounts on their hepatitis C treatments to keep them on reimbursement lists. CVS Health, Anthem and Humana chose Gilead drugs as their preferred treatment, while pharmacy benefits company Prime Therapeutics kept both on its list.
Wall Street analysts estimate the drugmakers have provided discounts of 30 percent or more. Gilead and AbbVie would not comment on the price reductions.
Some industry experts see Gilead and AbbVie gaining in terms of the number of patients treated now that they have conceded on price. Many insurers had limited use of the new hepatitis C drugs to the sickest patients to contain costs.
“The floodgates (of patients) could start to open over time this year,” said RBC Capital Markets analyst Michael Yee. He has forecast $15 billion for Gilead worldwide hepatitis C sales in 2015 and sees room for upside.
“That number starts to go up as we start seeing some of the prescription numbers come out,” he said.
Len Yaffe, portfolio manager of the StockDoc Partners healthcare fund, expects $18 billion in Gilead hepatitis C sales this year as more patients are covered for treatment.
Gilead’s new two-drug treatment, Harvoni, taken as one pill once a day, is expected to replace Sovaldi use. It has a list price of $94,500 for 12 weeks. AbbVie’s Viekira Pak, which involves more pills and drugs, and in most cases must be taken with the older medicine ribavirin, has a list price of $83,319 per treatment.