“While most payers cover about 75% of an enrollee's prescription drug costs, Medicare Part D covers 95% at high spending levels,” Mark Merritt, CEO of the Pharmaceutical Care Management Association, said in a statement. “The study shows taxpayers will bear the lion's share of the increased drug costs for Medicare Part D beneficiaries taking hepatitis C drugs.”
Milliman's analysis does not, however, include the effect of the drug therapy on other medical costs.
Last week, Gilead Sciences CEO John Martin predicted the hue and cry about Sovaldi's price tag will subside as more people are cured of hepatitis C, eliminating the cost of treating the disease as a chronic illness over a patient's lifetime.
Sales of the drug reached $3.5 billion in the second quarter of this year, accounting for more than half the company's total revenue and driving $3.66 billion in net income for the quarter.
On Monday, 333 patient groups from around the country, co-signed and sent a letter (PDF) to HHS Secretary Sylvia Mathews Burwell, arguing that health plans sold on the new insurance exchanges have too much leeway to exclude coverage for the expensive medications needed by patients with chronic conditions like hepatitis C.
Follow Virgil Dickson on Twitter: @MHvdickson