The nation's third largest insurer is the latest to find a cheaper way to bring a curative therapy to members with Hepatitis C.
Aetna has reached an agreement with Gilead Sciences "that will result in lower pricing for the hepatitis C drugs Harvoni and Sovaldi" for members, the company announced.
Based on the "efficiency and cost compared to other current hepatitis C treatments," Sovaldi and its all oral version Harvoni will be the preferred therapies for Aetna Commercial customers.
For the time being, Aetna is going with the first Hepatis C breakthrough, rather than the new similarly effective combination therapy called Viekira Pak sold by AbbVie, which other payers are embracing as part of first real price battle over a successful specialty medication.
At the same time, Aetna added that it will continue evaluating other hepatitis C drugs "to ensure that all customers have access to quality treatments."
Last year, Gilead's $84,000-per-treatment Sovaldi hit the budgets of many private and public payers hard, while also starting a debate about drug value and pricing.
As soon as Abb Vie won approval for Viekira Pak, the nation's largest pharmaceutical benefits manager, Express Scripts, wasted no time in making it the exclusive option for hepatitis C patients with the most common genotype, although it it later inked a deal with Gilead on behalf of Anthem Blue Cross's employer-sponsored health plans.
Earlier in January, CVS announced a deal with Gilead to make Sovaldi and Harvoni the exclusive treatment for hepatitis C patients on its drugs plans, which cover some 60 million Americans in Medicare, Medicaid and private insurance. Humana likewise went with Gilead to use Sovaldi and Harvoni as the preffered treatment.
Meanwhile, a Blue Cross-owned pharmaceutical benefits manager has crafted deals with each of the drug markers.
Prime Therapeutics, the Minnesota-based PBM collectively owned by 13 Blue Cross insurers, has inked deals with both Gilead and AbbVie to offer Harvoni and Viekira Pak as treatment for hepatitis C patients within its 25 million member base.
"There has been a substantial reduction in the net price of both of these drugs just in the past few weeks, so sometimes it pays not to go first," said Peter Wickersham, Prime's senior vice president of integrated care and specialty. "It was clear that neither Gilead nor AbbVie wanted to be left off our formulary and the result proved to be significantly better than taking an exclusive position."
Wickersham said the company negotiated with the drug makers on behalf of its 23 health plans and clients, together representing about 25 million members.
"Prime carefully evaluated all options, including an opportunity for an exclusive agreement with each company," said David Lassen, the company's chief clinical officer. "However, placing both Harvoni and Viekira on our formulary proved to be the lowest cost option for our clients and, importantly, prevents member disruption. We're pleased with the agreements we have signed with both companies and feel we're positioned well for the future in hepatitis C treatment."