Big Pharma faces up to new price pressure from aggressive insurers

Thu Jan 15, 2015 3:19am EST
 
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By Deena Beasley and Caroline Humer

SAN FRANCISCO (Reuters) - The world's biggest drugmakers face a new reality when it comes to U.S. pricing for their products as insurers use aggressive tactics to extract steep price discounts, even for the newest medications.

Big Pharma executives acknowledged the depth of change this week during public presentations and interviews with Reuters at the J.P. Morgan Healthcare conference in San Francisco. Drugmakers have long relied on their ability to charge whatever they deemed appropriate in the U.S., the world’s most expensive healthcare system.

Industry advocates have defended those U.S. prices in the past as a way to recoup the billions of dollars spent on experimental drugs that fail and to offset discounts offered overseas.

"There has definitely been increased price competition ... if a product is viewed as a commodity," Derica Rice, chief financial officer at Eli Lilly & Co (LLY.N: Quote), said in an interview. "Our goal is clinical differentiation."

Pascal Soriot, chief executive of AstraZeneca Plc (AZN.L: Quote), warned investors that the pressure exerted by health insurers has expanded from medicines used to treat common maladies to the specialized fields, like cancer, where drugmakers have been able to charge their highest prices.

"Payers will try to leverage their strengths to try and get pricing concessions because those agents are very expensive," Soriot said.

Many say the tide shifted with a campaign by insurers and pharmacy benefits companies against Gilead Sciences Inc's (GILD.O: Quote) $84,000 hepatitis C treatment Sovaldi. The drug represented the first effective cure for hepatitis C and quickly raked in billions of dollars in sales within its first few months on the market in 2014. Sovaldi's cost is based on a 12-week treatment regime and amounts to $1,000 a pill. By contrast, the treatment costs about $57,000 in the U.K.

As soon as U.S. regulators approved Sovaldi's competitor, a treatment from AbbVie Inc (ABBV.N: Quote), last month, the country's largest pharmacy benefits manager Express Scripts Co ESRX.O dropped reimbursement for the Gilead drug.   Continued...

 
Pharmaceutical tablets and capsules in foil strips are arranged on a table in this picture illustration taken in Ljubljana September 18, 2013.  Picture taken September 18. REUTERS/Srdjan Zivulovic