AHF Criticizes Gilead for Blacklisting Hepatitis C Patients from Drug Assistance Programs to Punish Insurers

In News by AHF

The WSJ’s Pharmalot blog reports that many Hepatitis C patients are now being pushed out of Gilead’s Patient Assistance Program, “…which helps people obtain the Sovaldi and Harvoni treatments when they lack sufficient insurance coverage or the financial wherewithal to get the medicines otherwise.”

“…The drug maker is taking this step after finding that some payers, despite receiving discounts in recent months, have continued to restrict patient access to its hepatitis C medicines.”

WASHINGTON (July 23, 2015) AIDS Healthcare Foundation (AHF), the largest global AIDS organization and a vocal critic of runaway drug pricing and drug profiteering, today blasted Gilead Sciences and its CEO John Martin over news that the Bay Area drug giant is pushing certain Hepatitis C patients from its lifesaving Gilead Patient Assistance Programs (PAP). If a patient’s health insurer refuses to cover, or puts limits on their coverage of Gilead’s Hepatitis C drugs even after being offered manufacturer discounts, the drug company—which reported $12.1 billion in profits in 2014—is moving to retaliate by disqualifying thousands from its PAP. Nearly all the major drug companies have some form of patient assistance programs to help patients who have no medical insurance, lack adequate insurance access or are facing other difficulty accessing lifesaving medications.

According to a July 16th article by reporter Ed Silverman on the Wall Street Journal’s Pharmalot blog, as of July 1st, Gilead is now removing and excluding some insured patients from participation its patient assistance program if they are hepatitis patients in need of medications like Sovaldi—Gilead’s twelve-week Hep-C drug regimen that costs $84,000—or Harvoni, a similar, even more expensive hepatitis treatment priced at $94,000. This appears to be the first time a drug company has so brazenly and callously decided to deny patients access to medications via patient assistance as a bargaining strategy with, or punitive measure against, health insurers unable or unwilling to pay such enormous premiums for drugs.

“If a patient’s insurer balks at paying the $1,000 per pill cost of Sovaldi or the $94,500 cost of Harvoni, Gilead may now deny the patient medication access via its own patient assistance program,” said Michael Weinstein president of AIDS Healthcare Foundation. “In essence, Gilead is holding Hepatitis C patients hostage as a negotiating strategy with health insurers for drugs that they ridiculously overpriced in the first place, so whatever discounts Gilead offered are most likely rendered moot. Gilead has always been at the forefront in overpricing its medications as well as price gouging government programs, but this is entirely new territory—it so plainly shows what little regard and compassion Gilead actually holds for patients. Blacklisting these patients is nothing more than a means for Gilead to pressure—shake down, really—the patients’ insurers.”

In a bittersweet understatement in a community letter sent earlier this month by Coy Stout, Gilead’s VP for Managed Markets, Gilead advises that,

“For Sovaldi and Harvoni patients who are insured and have been denied coverage by their payer, Support Path (Gilead’s PAP) can assist patients with the requirements for submitting appeals, peer reviews and understanding the process for in-person hearings if required.”

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