Express Scripts to Cover Viekira Pak, Exclude Sovaldi

Multi-year agreement with AbbVie will place new drug as the exclusive option for patients with hepatitis C genotype 1.

In the wake of last week’s approval by the FDA of AbbVie’s breakthrough hepatitis C treatment Viekira Pak, Express Scripts yesterday announced an update to its National Preferred Formulary to expand access to the drug.

Viekira Pak will be immediately added to the Express Scripts formulary as the exclusive option for patients with genotype 1 hepatitis C, regardless of symptoms or disease progression, starting January 1, 2015. Sovaldi, Harvoni and Olysio will be excluded from the Express Scripts formulary, however the drugs will continue to be available for patients who have already begun treatment.

Additionally, Sovaldi will also be available for patients with other hepatitis C genotypes who have advanced liver disease.

"Express Scripts and AbbVie have a single focus: do what's right for hepatitis C patients," Steve Miller, MD, senior vice president and chief medical officer of Express Scripts, said in a press release. "For the first time, a pharmaceutical manufacturer and a pharmacy benefit manager have created an agreement to deliver on the promise of a curative therapy for hepatitis C patients. Pharmaceutical innovation must be rewarded based on the value it brings to patients and payers. This agreement marks a fundamental change in how sustainable access and affordability will be delivered to hepatitis C patients."

Through the Express Scripts Hepatitis Cure Value Program, Viekira Pak will be dispensed through the Accredo Specialty Pharmacy.

Viekira Pak contains ombitasvir, paritaprevir, and ritonavir tablets copackaged with dasabuvir tablets.

A clinical trial for Viekira Pak enrolled 2308 patients with chronic HCV infection with and without cirrhosis. The subjects took either Viekira Pak or placebo, Viekira Pak with or without ribavirin, or Viekira Pak with ribavirin for 12 or 24 weeks.

The results showed 91% to 100% of patients who received the recommended dosing of Viekira Pak achieved sustained virologic response (SVR) after at least 12 weeks, according to the FDA.

Viekira Pak will be available for all clinically appropriate plan members covered by the Express Scripts formulary, which is in contrast to more costly hepatitis C medications that many payers were only covering for patients with stage 3 or 4 liver disease.

"If the specialty drug trend continues to increase by double digit percentages, payers will be forced to implement even more narrow management tools, thus limiting the number of patients who can afford to receive the drug therapy," Paula Jakub, CEO of Express Script client American Foreign Service Protective Association, said in a press release. "It only makes sense for manufacturers to work with payers on pricing decisions. We are delighted to be a partner in this relationship to explore new approaches for the right person to receive the right drug at the right time."