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In a sign that price competition may take hold for hepatitis C drugs, the nation’s largest manager of prescriptions will require all patients to use AbbVie’s newly approved treatment rather than two widely used medicines from its rival Gilead Sciences. (Pollack, 12/22)

Express Scripts, which has been critical of the cost of Gilead’s treatments, said on Monday it had negotiated to receive a discount from AbbVie on the $83,319 wholesale price of the multidrug Viekira Pak, a standard 12-week course of treatment that was approved by U.S. regulators on Friday. In exchange, Express Scripts will no longer pay for Gilead’s drugs for patients with a type of hepatitis C known as genotype 1, representing about two-thirds of the people with the viral liver disease. (Walker, 12/22)

The U.S. Food and Drug Administration approved AbbVie’s Viekira Pak, an all-oral cocktail of several drugs that cured more than 90% of people with the most common subtype of hepatitis C in the U.S., genotype 1, in clinical trials. The regimen consists of several pills taken daily for about 12 weeks for most patients, eliminating the need for an older injected drug, interferon, which many patients find difficult to tolerate. (Loftus, 12/19)

About 3.2 million Americans are infected with hepatitis C, which generally doesn't cause noticeable symptoms until the liver is damaged. Without proper treatment, up to 30 percent of those people will eventually develop cirrhosis, an advanced liver disease in which excessive alcohol, fat and other substances kill off liver cells, causing scarring of the liver tissue. The virus can cause liver failure and liver cancer, resulting in the need for a liver transplant.(Johnson, 1219)

Insurers and state Medicaid programs have been eagerly awaiting the approval of the AbbVie regimen, which is called Viekira Pak, hoping that competition will drive down prices. But price competition might be limited. (Pollack, 12/19)