Express Scripts Holding Co. will not cover hepatitis C medicines from Gilead Sciences Inc., Merck & Co. Inc., Bristol-Myers Squibb Co. and Johnson & Johnson, among other medicines on its updated formulary for 2018.
Gilead's Sovaldi, Merck's Zepatier, Bristol-Myers' Daklinza and J&J's Olysio have been excluded from the pharmacy benefit manager's preferred medicines for the year, a list that established the main products covered by insurers for about 83 million patients.
Meanwhile, Gilead's hepatitis C medicines Harvoni and Epclusa made the preferred list, along with the newer and less expensive Mavyret from AbbVie Inc.
Hepatitis C medicines have been a key driver of U.S. prescription drug expenses, according to a report from the Centers for Medicare and Medicaid Services in December 2017. Gilead's Harvoni and Sovaldi each have a list price of roughly $1,000 a pill for an eight- to 12-week treatment cycle and made billions of dollars annually when they first launched.
Sovaldi made $219 million in third quarter 2017, down from $825 million a year prior. Harvoni's sales also fell as the hepatitis C population in the U.S. dwindled; it dropped from $1.8 billion in the third quarter of 2016 to $973 million in the latest quarter.
Mavyret, which launched in August 2017 at a significantly lower list price, made $500 million in the year. Gilead will report its full-year earnings Feb. 6.
PTC Therapeutics Inc.'s Emflaza and Sarepta Therapeutics Inc.'s Exondys 51, both Duchenne muscular dystrophy medicines, were also excluded from the new formulary, which will go into effect March 1. Emflaza has attracted controversy since its planned launch by Marathon Pharmaceuticals LLC for $89,000 annually despite already being used as a steroid at a significantly cheaper price. PTC Therapeutics bought the medicine after criticism delayed its launch and earlier this year announced that it would retail the hereditary muscular disorder medicine for $65,000 a year, a 9% bump to PTC's original price.
The drugs join a list released in July 2017 that excluded Eli Lilly's osteoporosis drug Forteo and Amgen's post-cancer treatment Neupogen, along with other branded products that have cheaper alternatives on the market. Several opioids were also excluded, including Opana ER from Endo Pharmaceuticals, which was pulled off the market last year, and the generic oxycodone ER.
