Friday, April 25, 2014


Following up on Wednesday's post about the expensive  new "Hep C' drugs, the FEHBlog noticed a fascinating Wall Street Journal article this morning about the vexatious impact of the new Hepatitis C drugs on U.S. prisons where a large percentage of inmates are infected by the disease,  which is communicated by sexual contact and contact with infected blood. The article explains that
Spending on hepatitis C already had been on the rise * * * due to the 2011 introduction of two drugs that added about $50,000 in costs per patient. The drugs, known as protease inhibitors and sold by Merck & Co. and Vertex Pharmaceuticals Inc. generally improved cure rates to a range of 66% to 79% for people with the most common type of hepatitis C, from 40% to 45% for older drugs.
Sovaldi [manufactured by Gilead - price $84,000 for a course of treatment], when added to two older drugs, can shorten treatment duration to as little as 12 weeks from 48 weeks for the older drugs, while improving cure rates to about 90% for the most common type of hepatitis C. Olysio [manufactured by Johnson & Johnson -- $66,000 for a course of treatment], which is typically given for 12 weeks combined with at least 24 weeks of the two older drugs, has shown a cure rate of about 80% for the most common type of the disease.
Note that the cost per patient for a course is treatment is $134,000 for Sovaldi and $116,000 for Olysio because the new drugs must be taken in combination wth the somewhat older drugs.  Paradoxically, the Federal Bureau of Prisons gets a 44% discount on these drugs from a VA program which is not available to state prison bureaus. The FEHBlog's dad jokingly told him that the proper pricing policy is to stick the knife in the customer's back and twist it two times and then turn it back a half turn to reach a fair price. These drug companies take this joke literally.

The Drug Channels blog writes about the Drug Store News rundown of the top fifty chain pharmacies in the U.S. Drug Channels also notes some differences between DNS's list and their list, e.g., DNS does not include the country's thrid largest dispensing pharmacy which is Express Script's mail order pharmacy. Of course the number 1 pharmacy chain on DNS's list CVS owns the other major prescription benefit manager.

Kaiser Health News writes about the manner in which doctors are becoming more aggressive in collecting bills from their patients. It's always interesting to look at the other side of the coin. The FEHBlog does miss the AMA News.

Finally, CIGNA this week released its eighth annual experience study on its consumer driven plans. CIGNA is finding that these plans do bend the cost curve down.

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