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CVS Caremark JAMA Commentary: New Hepatitis C Treatments Highlight Need to Control Costs of High-Priced Specialty Medications
Date:7/21/2014

WOONSOCKET, R.I., July 21, 2014 /PRNewswire/ -- A new Journal of the American Medical Association (JAMA) commentary published online today and scheduled to appear in the August 13 print edition addresses the controversy surrounding the high costs of new Hepatitis C Virus (HCV) treatments such as Sovaldi (sofosbuvir) and implications for the growing specialty pharmacy market. CVS Caremark (NYSE: CVS) Chief Medical Officer Troyen A. Brennan, M.D., and Chief Scientific Officer William Shrank, M.D., suggest that the discussion to this point has focused inappropriately on price per pill, rather than on total cost to the health care system.

"Perhaps the controversy about sofosbuvir is really about the increasing total cost of specialty medications, considering both cost and prevalence of treatment targets," the authors write. "While a daily oral medication that costs $1,000 per pill gains attention, the more important issue is the number of people eligible for treatment. Sofosbuvir is not really a per-unit cost outlier, but is a 'total cost' outlier because of its high cost and very large population eligible for treatment— a beacon for costs of specialty medications generally."

While HCV treatment options have improved dramatically over the past three years, with cure rates up to 95%, new therapies such as sofosbuvir can cost patients $84,000 for a standard 12-week course of therapy – or roughly $1,000 per pill. Utilizing sofosbuvir as an example, the commentary analyzes the price of HCV medications in the context of the cost of investment and of comparative treatments, and finds that the issues are much more nuanced than previous discussions focusing on cost per pill alone.

The authors also explore the many different efforts currently underway to control overall costs. For example, some sta
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