CA panel deems Sovaldi a "low value" treatment

California Technology Assessment Forum members give a "low value" rating to Gilead's (GILD) pricey hepatitis C treatment Sovaldi citing its high cost. The vote is non-binding but could influence coverage decisions by payers.

The panel agrees that not all hep C patients require the most expensive drugs. If California treated every patient with liver damage it would cost the state over $6B.

Sovaldi's treatment regimen costs $84,000 compared to $66,000 for J&J's (JNJ) Olysio.

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Comments (13)
  • aow
    , contributor
    Comments (151) | Send Message
    Oh an insurance industry group creates a report saying they don't want to pay for pricey drugs, what a surprise! In other news, a new study shows consumers want lower prices.
    12 Mar 2014, 12:00 PM Reply Like
  • Leonard Yaffe
    , contributor
    Comments (168) | Send Message
    I attended the panel meeting. While I commend the data analysis, it is important to be aware of the composition of the panel as well as factors excluded from analysis and relevant assumptions made before drawing conclusions. Additionally, most payers in California , including Health Net, Anthem, Aetna and Humana, have established criteria for prior authorization approval. Of note is the recognition of the superior efficacy and improved side effect profile of sofosbuvir in most subpopulations (based on genotype, prior therapy, interferon eligibility). Len
    12 Mar 2014, 12:08 PM Reply Like
  • tarheelboy
    , contributor
    Comments (364) | Send Message
    All ins companies not wanting to pay. Should be a law against the fox deciding how to protect the henhouse!
    12 Mar 2014, 12:15 PM Reply Like
  • ash187
    , contributor
    Comments (222) | Send Message
    So the private insurance industry is adopting...death panels???
    12 Mar 2014, 12:16 PM Reply Like
  • tothman
    , contributor
    Comments (13) | Send Message
    I'm not sure if I would apply the term "low value" to a treatment that could potentially eradicate the Hep C virus from the planet...
    12 Mar 2014, 01:31 PM Reply Like
  • combatcorpsmanVN
    , contributor
    Comments (1390) | Send Message
    $GILD - well, when it comes to 'low value', Insurance Carriers set the standard. When it comes to collecting Premiums, the industry is all for it. When it comes to paying claims on the coverage that they took the Premium for, there's always some reason to renege by these Carriers.


    So, when a person's life is in the balance and there is a drug regimen that now provides over 90% efficacy, the Carriers don't want to pay up -- even though standard treatments currently aren't effective, take longer, and wind up being more expensive.


    Sounds like a full employment act for plaintiff's attorneys - Class Actions brewing??
    12 Mar 2014, 02:09 PM Reply Like
  • Teriee
    , contributor
    Comments (109) | Send Message
    19 Mar 2014, 07:08 PM Reply Like
  • Hepper Bozo
    , contributor
    Comments (7) | Send Message
    I'm 5 weeks into Trial Gilead for post liver transplant patients. Transplant 2001. My count has gone from 3 mil + per liter, to 905. No side effects worth mentioning.
    12 Mar 2014, 02:36 PM Reply Like
    , contributor
    Comments (45) | Send Message
    Congrats Hepper
    12 Mar 2014, 06:26 PM Reply Like
  • GaryLee276
    , contributor
    Comments (151) | Send Message
    going to zero Hepper!
    12 Mar 2014, 09:29 PM Reply Like
  • value investor12
    , contributor
    Comments (10) | Send Message
    Previous standard of care usually included IFN + ribavirin + a 1st generation protease inhibitor. It caused a lot of side effects leading to many follow ups, possible admissions, management of the side effects with certain drugs, etc which leads to extra costs other than the drug itself. If you consider all this I do not think that SOF's price is unreasonable, although I do agree with the moral argument that it is wrong for people who do not have money to not be offered this life saving drug. Pricing is always tricky for this reason.
    12 Mar 2014, 11:27 PM Reply Like
  • the humble scribe
    , contributor
    Comments (197) | Send Message
    The saying is ''build a new and more efficient mousetrap and they will come knocking at your door''. And Hepper Bozo here above is the proof of the efficiency. Now if only there were a couple of doctors suffering from liver desease sitting on this pannel perhaps the panel would come up with a different conclusion. We are talking here about a life saving drug folks.
    13 Mar 2014, 06:04 AM Reply Like
  • ptrummer
    , contributor
    Comments (87) | Send Message
    Huge huge mistake! Pay me now or pay me later!
    Deny the Sovaldi now and pay for the liver transplant later!
    Wait until the lawsuits start to flow!
    Insurance companies should know better.
    If I have Hep C, I get my hands on this as soon as possible.
    Improves quality of life immediately, FDA approved!
    No brainer!
    14 Mar 2014, 02:15 AM Reply Like
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