CVS Health Research Institute data examines uptake of new hepatitis C treatments
WOONSOCKET, R.I. — The CVS Health Research Institute released a first look at the comparative utilization of two new hepatitis C treatments in the weeks following their respective launches.
The analysis shows an increase in the number of eligible hepatitis C patients being treated following the October launch of Harvoni (ledipasvir and sofosbuvir), the newest hepatitis C treatment. Uptake for Harvoni is approximately 2.5 times the rate of Sovaldi (sofosbuvir) prescribing during the weeks following Sovaldi’s launch in December 2013. In addition, the data shows there has been minimal reduction in Sovaldi use following the launch of Harvoni, suggesting an expansion in the pool of patients being treated, rather than Harvoni being used as a substitute for Sovaldi.
“The high price of these new hepatitis C treatments and the expanding pool of patients receiving treatment signal a growing and costly trend in treating chronic medical conditions with specialty medicines,” stated Troyen A. Brennan, chief medical officer at CVS Health, who coauthored the report. “Hepatitis C is just the beginning, and we need to prepare now for the time when large numbers of patients could be treated effectively with high-cost medicines for a variety of common and more complex conditions.”
The report analyzes de-identified CVS/caremark data and compares Harvoni prescriptions to Sovaldi prescriptions during the eight weeks post launch for each treatment. Data shows that the number of Harvoni prescriptions (>7,500) were approximately 2.5 times higher than Sovaldi prescriptions (>3,000) during the post-launch period for each drug. Moreover, the authors find that Sovaldi use since the introduction of Harvoni has only declined modestly. The new data suggests that the number of eligible patients being treated for hepatitis C is expanding overall with each therapy continuing at high utilization rates.
“As new therapies enter the market, particularly in categories such as hepatitis C where treatment costs are high, CVS Health is focusing on strategies to control costs, while improving patient health outcomes,” stated Alan Lotvin, EVP of CVS/specialty at CVS Health. “These will include utilization management and formulary approaches to ensure the most cost-effective, clinically appropriate therapy. We also provide comprehensive, patient-centered support to maximize the successful completion of therapy.”
With the ongoing impact of expensive specialty medications on payers’ budgets, CVS/caremark and the company’s specialty pharmacy have activated a number of tools to manage cost, while ensuring patient health outcomes. For hepatitis C therapy, CVS/caremark coordinates utilization management and prior authorization strategies to drive evidence-based decision making.
These tools help identify patients who will best respond to therapy in order to optimize efficacy and reduce unnecessary costs. In addition, thoughtful formulary placement plays an important role. As new and equally effective treatments from other manufacturers are expected to enter the market shortly, aggressive negotiation on price combined with the development of formulary tiers or exclusions can help manage costs for payers, CVS Health stated.
CVS Caremark Specialty Pharmacy also provides patient-centered care through its Specialty CareTeams. These CareTeams include clinicians with disease-specific expertise, along with embedded disease management nurses who address the patient’s overall condition, including comorbidities, lifestyle concerns and counseling on any non-specialty prescriptions the patient is using. CVS Health also makes it easier for patients to start on therapy with Specialty Connect, a program that allows patients who present specialty prescriptions at any CVS/pharmacy store to receive centralized benefit guidance and CareTeam support from CVS Caremark Specialty Pharmacy.