by Richard Staines
LONDON, Jan 14 (APM) - The price of Gilead's hepatitis C drug, Sovaldi (sofosbuvir) has highlighted a major weakness in the U.S. health system and its patchwork of private health insurers in that expensive drugs offering long-term savings are not properly funded, Europe's pharma trade body leader has told APM.
The U.S. does not have a single payer model but a series of competing payers that will provide services for patients for a limited period of time, noted Richard Bergstrom, director general of the European Federation of Pharmaceutical Industries and Associations (EFPIA).
In an interview to discuss the world of pharma in 2015 (APMMA 41089), he argued the U.S. system was less willing to fund drugs like Sovaldi with high up-front costs because individual payers are unlikely to see the financial benefit from a cured patient - who may well be paying premiums to a different provider next year.
Gilead has justified the high cost of Sovaldi by arguing it saves health systems money in the long term by reducing hospital visits and care for patients seriously ill with hepatitis C, but the issue of funding similar treatments will need further debate on the other side of the Atlantic, argued Bergstrom.
“Because in the U.S. you can change provider every year, there is no incentive for drugs that bring health benefits in the long term. "The U.S system seems unable to cope with that," he stressed.
The largest U.S pharmacy management firm last month stopped funding Sovaldi for most patients and has instead struck a deal with AbbVie to pay for its cheaper Viekira Pak (ombitasvir+paritaprevir+ritonavir+dasabuvir). (APMMA 40928)
Bergstrom noted that in Europe, Gilead, which is not an EFPIA member, had succeeded in marketing the product by negotiating with national payers.
He argued that despite initial concerns over Sovaldi's price, of more than 40,000 euros per 12-week course, “nothing (seriously detrimental) happened” in Europe and instead there was a round of pricing negotiations that led to a resolution in most cases.
In line with comments made at the International Society of Pharmacoeconomics and Research (ISPOR) conference in Amsterdam in November (APMMA 40412), Bergstrom said healthcare systems must learn from the controversy over the price of Sovaldi.
Health systems should attempt to predict when “disruptive” inventions such as Sovaldi are about to hit market and plan accordingly, he argued.
The pharma pipeline is likely to bring more innovations to market, starting this year with drugs such as Novartis's heart failure agent LCZ696, which is subject to a fast-track review by the European Medicines Agency (APMMA 40609).
If approved this drug will probably be marketed like a traditional cardiology blockbuster, Bergstrom said.
He told APM: “2014 was the year when pipelines were full. But we have a huge challenge of affordability and paying for these.
“Next time this should not happen. You have to be able to plan for the disruptive inventions, while at the same time companies are becoming more flexible on price. You have to realise that there is a new way to work.”
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