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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

te Medicaid programs have not added new HCV medications to their formularies, despite new practice guidelines. Other states are delaying the addition of sofosbuvir until they can arrange a level of state subsidization, and many private insurers have instituted prior authorization programs to manage costs. Some public and private care coordinators are asking physicians to treat only those patients who absolutely need therapy now, as new treatment options anticipated later this year are expected to help lower costs.

Brennan and Shrank add: "A value-driven approach to pricing focuses on how treatment with sofosbuvir compares with other treatments for HCV infection. Value also has to consider the efficacy of treatment, and requires more sophisticated cost-effectiveness analyses, such as the incremental cost-effectiveness ratio, representing the added cost of an additional quality-adjusted life-year."

The authors say the health care system needs to adjust more quickly to the growing cost and utilization of specialty medications across a variety of conditions. "This is not an isolated phenomenon; other expensive specialty medications are in development, many with large potential pools of targeted patients. Effective approaches to control costs for high priced medications need to be developed and evaluated to ensure broad, equitable, and appropriate use of these new interventions in an already stressed health care system."

For access to the full JAMA commentary, please visit: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2014.8897

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CVS Caremark is dedicated to helping people on their path to better health as the largest integrated pharmacy company in the United States. Through the company's more than 7,600 CVS/pharmacy stores; its leading pharmacy benefit manager serving more than 64 million plan me
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