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Randi Hernandez was science editor at Pharmaceutical Technology from September 2014 to May 2017.
The exclusivity deal mirrors that of the recent deal between Express Scripts and AbbVie for Viekira Pak.
In what appears to be an answer to Express Scripts’ decision to exclusively offer hepatitis C drug regimen Viekira Pak (ombitasvir/paritaprevir/ritonavir with dasabuvir), CVS confirmed on Jan. 5, 2015 that it will exclusively offer Gilead's Harvoni (ledipasvir and sofosbuvir) and Sovaldi (sofosbuvir) to members through its CVS/Caremark commercial, exchange, Medicare Part D, and Medicaid formularies.
According to Evercore ISI analyst Mark Schoenebaum, while the AbbVie/Express Scripts deal covers nearly 25 million lives, the CVS arrangement with Gilead could actually affect more than 25 million lives, as CVS has a much greater involvement in Medicaid, especially when it comes to managed Medicaid. CVS said in its 2013 analyst day report that its pharmacy benefit manager (PBM) alone controlled 28% of the lives enrolled in managed Medicaid in 2013, making the company the leading PBM in the managed Medicaid market that year.
The jury is still out on the extent of the discount CVS received to solely offer Gilead’s medications, as Schoenebaum points out. He also notes that the duration of the exclusivity remains unclear and companies like Aetna, which has an agreement with CVS, will still make their own formulary decisions. The deal reduces pill burden for CVS clients, as Harvoni and Sovaldi have less complicated regimens than that of Viekira Pak.
“Our goal was to create the lowest net-cost solution for the entire population of patients with all genotypes of Hepatitis C,” CVS spokeswoman Christine Cramer said in statement in MarketWatch. “When making this decision, we evaluated a wide variety of factors including duration of therapy, relative distribution of genotype, and cost of the individual agents in the category as well as the results of a comprehensive clinical review of the different hepatitis C regimens.”