Hepatitis C Drug Spending Continues to Skyrocket

Exchange plan spending on hepatitis C drugs increased 96% in the first quarter of 2015.

Spending on new hepatitis C drugs continued to skyrocket in 2015, according to a report recently released by Express Scripts.

The Express Scripts Exchange Pulse report found that spending on hepatitis C drugs for patients in an exchange plan jumped 96% in the first quarter of 2015 compared with the same period last year. The report compared the annual prescription medication use among people enrolled in exchange plans with individuals enrolled in a traditional health plan.

"Exchange plans have an opportunity to make medications more affordable and accessible by more closely managing the benefit, encouraging the use of home delivery pharmacy and other proven clinical pharmacy programs, which can help boost medication adherence and foster better disease management,” said Julie Huppert, vice president of health care reform at Express Scripts, in a press release.

Researchers analyzed more than 100 million de-identified pharmacy claims administered by Express Scripts over a 15-month period from 2014 to 2015.

The findings showed that patients newly enrolled in exchange plans in early 2015 were healthier and spent less money on prescription drugs than enrollees in the first quarter of 2014, which helps to balance risk among the pool of insured customers in exchange plans, according to Express Scripts.

Exchange plan medication trends showed that spending on high cost specialty drugs increased 24%, compared with an 8% jump in traditional plans, largely as a result of hepatitis C drugs, according to the report. Treatments like Sovaldi and Harvoni can cost in excess of $84,000 for a 12-week treatment course.

Data from the analysis showed 42% of all pharmacy spending went to pay for specialty medications, including drugs for hepatitis C and HIV. The greater spending on specialty drugs partially contributed to a 16% jump in per-member, per-month costs among exchange plans compared with traditional health plans.

The two most expensive specialty drugs for exchange plan members were Harvoni and Sovaldi, both produced by Gilead Sciences. Plans that participate in a hepatitis C value program offered by Express Scripts can expect to pay less in the HCV drug class in 2015, the company said.

In late-2014, Express Scripts announced an exclusive deal with AbbVie Inc for an updated formulary that offers Viekira Pak at an undisclosed discount.

The report also indicated that a greater number of patients in exchange plans are not taking their medication as prescribed. Non-adherence was highest among patients taking drugs for diabetes, high blood pressure, hepatitis C, and HIV, with 4 out of the 10 costliest conditions covered by exchange plans.

"While it is encouraging to see data that suggests healthier Americans are enrolling in exchange plans, the research reminds us that many of these patients use this benefit to manage serious, chronic illnesses," Huppert said.