Harvard Pilgrim Health Care, one of the largest not-for-profit health insurers in New England, said it will save millions of dollars in hepatitis C drug costs through its negotiated pricing discount from pharmaceutical giant Gilead Sciences.
Wellesley, Mass.-based Harvard Pilgrim will receive a lower price for Harvoni, Gilead's newest hepatitis C drug. In exchange, the one-tablet Harvoni will become the preferred drug for the insurer's covered patients who have hepatitis C genotype 1, the most common version of the liver disease.
Harvard Pilgrim, which provides health coverage to more than 1.22 million people, did not disclose how steep a discount it received from Gilead. Harvoni normally costs $94,500 for a full 12-week course of treatment.
The deal has some restrictions. The discount applies only to hepatitis-C patients who have advanced liver scarring or cirrhosis, specifically those with fibrosis scores between F2 and F4. Harvard Pilgrim said it also will cover other hepatitis C drugs “when clinically appropriate.”
“This is a win-win for patients, for employers who subsidize their employees' health insurance, and for all who have a stake in ensuring that the dollars we spend on healthcare are used wisely,” Harvard Pilgrim Chief Medical Officer Dr. Michael Sherman said in a statement.
Harvard Pilgrim's exclusivity deal is the latest iteration of the hepatitis C drug pricing battle. Numerous other insurers, including Aetna, Anthem, Humana and UnitedHealthcare, have negotiated similar discounts with Gilead. Only one company, pharmacy benefits manager Express Scripts, has designated AbbVie's Viekira Pak as its preferred hepatitis C drug.
Gilead will report fourth-quarter and full-year earnings Tuesday. AbbVie will release its results Friday.
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