Four months after congressman Henry Waxman’s (D-CA) original note to Gilead on the matter, political fervor over Sovaldi’s pricing continues to simmer. This time, it’s the Senate Finance Committee’s turn to grill the drugmaker.
Oregon Democrat Ron Wyden and Iowa Republican Charles Grassley penned a letter to Gilead’s CEO last Friday with an 21-point list of questions ranging from Gilead’s intended promotional efforts and spend, to how much Sovaldi’s original owner, Pharmasset, initially planned to charge for the drug.
Justification for the laundry list of questions came from speculation that government programs Medicare and Medicaid as well as treatment for the 1.8 million infected people currently incarcerated could signal a significant increase in federal and state medical costs.
“Healthcare experts [citing Health Affairs] recently estimated that Sovaldi alone could increase Medicare’s spending on prescription drugs by $2 billion between 2014 and 2015…the DOJ has recently approved Sovaldi for use in treating prison populations…American taxpayers could end up paying billions of dollars buying Sovaldi to treat inmates infected with HCV,” the two senators wrote.
While the finance committee rightly points out that Sovaldi may be costly, what’s conveniently left out of their argument is the cost of treating a patient with sofosbuvir vs. that same patient receiving a liver transplant—as well as the fact that Sovaldi’s price is not set at a premium, even though it is a substantial improvement over alternative treatments.
The previous standard care of care—peginterferon-coupled antivirals like Merck’s Victrelis and Vertex’s Incivek—carried sticker prices of $80,000 and $100,000 for the duration of treatment, respectively, while Sovaldi costs $84,000 for a 12-week course of therapy. Patients with genotype 1 and 3, though, do require longer treatment, and their Sovaldi tab could reach as high as $168,000.
In a statement on the finance committee website, the two senators, citing SEC documents, assert that Pharmasset had planned to “profitably” sell the drug in the United States for $36,000—$48,000 lower than Gilead’s price point. Insurance lobbying group AHIP (American Health Insurance Plans) also blogged today that, after this information was uncovered, “Sovaldi’s price just got a lot harder to defend.”