Humana CEO Bruce Broussard told investors in a breakout session that it has a pricing arrangement with Gilead, but he did not disclose what kind of discount the health insurer received for the pricey drugs. High specialty drug costs were part of the reason why Humana's profit was lower in the third quarter.
The company's announcement is the latest in a string of bargaining battles between health insurers and pharmacy benefits managers and pharmaceutical companies. Anthem was the first payer to announce an agreement, saying last week it would use Gilead's drugs for its hepatitis C patients. Gilead makes Sovaldi and Harvoni, which cost $84,000 and $94,500 respectively for the usual 12 weeks of treatment.
Express Scripts started the trend in December when the pharmacy benefits manager said its primary hepatitis C option would be AbbVie's Viekira Pak, which costs $83,320 pre-negotiation. CVS Health struck a deal with Gilead soon after. None of the companies have elaborated on what the discounts look like.
Dr. J. Mario Molina, CEO of Medicaid managed-care insurer Molina Healthcare, told Modern Healthcare in December his company would be “taking a very serious look” at these types of exclusivity deals. But in an interview at the J.P. Morgan Healthcare Conference in San Francisco, Molina said there was nothing set in stone despite high prices representing a “significant cost.” The company will look at hepatitis C drug options on a state-by-state basis.
Not everyone is convinced the deals are beneficial. Some doctors are concerned the trend may be taking control away from their decision process. And not all payers believe the negotiated discounts will drastically reduce the overall cost of healthcare.
“If they were pricing it to consumer(s), you wouldn't even be close to what they are charging for it,” Mark Ganz, CEO of Cambia Health Solutions, the parent company of Regence BlueCross BlueShield health plans, said of Gilead's hepatitis C drugs.
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