Glecaprevir/Pibrentasvir

摘要:十年前，吉利德与艾伯维围绕丙肝特效药展开的定价大战，改写了医药市场竞争规则。如今，诺和诺德与礼来在肥胖治疗领域的 GLP-1 类药物价格厮杀，正以相似却又不同的轨迹上演。这场跨越病种的价格博弈，背后是政策压力、市场需求与治疗属性的多重交织。丙肝战场：治愈系药物的价格肉搏 2013 年底，吉利德的丙肝药索磷布韦（Sovaldi）横空出世，12 周疗程治愈率惊人，却以每瓶 2.8 万美元的定价引发争议，相当于每日 1000 美元的治疗成本。次年，吉利德推出复方药哈瓦尼（Harvoni），12 周疗程标价高达 9.5 万美元，进一步巩固市场优势。 艾伯维的入局打破了垄断。2014 年底，其维帕他韦 / 伏西瑞韦组合（Viekira Pak）以 8.3 万美元的标价，较哈瓦尼低 12% 的价格抢占市场。保险公司迅速站队，快捷药方公司甚至将其列为首选，取代哈瓦尼。迫于压力，吉利德 2015 年将两款药物降价 46%，艾伯维后续推出的新一代药物麦维雷特（Mavyret）更是将 8 周疗程价格压至 2.64 万美元，直接导致吉利德丙肝药销售额从 2017 年的 91 亿美元暴跌至 2018 年的 37 亿美元。 这场战役的特殊性在于，价格成为市场竞争的核心武器，而非传统的疗效差异。艾伯维后期因药物副作用调整标签，但凭借持续的价格优势，仍占据了重要市场份额。肥胖药战场：GLP-1 的新博弈 如今，诺和诺德与礼来正在肥胖治疗领域复刻相似剧情。诺和诺德的司美格鲁肽（Wegovy）与礼来的替尔泊肽（Zepbound）上市初期标价均超每月 1000 美元，而本月白宫宣布的定价协议中，两款药物价格已降至每月 350 美元左右。 不同于丙肝药的是，肥胖药面临独特的市场环境。医保普遍不覆盖减肥适应症，患者需自费购买，催生了直接面向消费者的折扣渠道。礼来通过 LillyDirect 在沃尔玛推出 349 美元 / 月的定价，诺和诺德则通过返利将实际成本降至每月 224 美元甚至更低。 政策压力成为关键推手。特朗普政府持续向药企施压要求降价，而肥胖作为慢性疾病，患者需长期用药，这与丙肝药 “一次性治愈” 的属性截然不同，也让定价策略更具复杂性。两场战役的同与不同 两场定价战的核心相似点在于，均由市场先入者高价布局，后发者以降价破局。丙肝与肥胖均为公共卫生重点领域，药物均具备高成本效益，却因庞大的患者基数引发可及性争议。 差异同样显著。丙肝药是治愈性治疗，肥胖药需终身服用，预算影响完全不同。医保覆盖情况的分化，让肥胖药市场更依赖消费者自主选择，也加速了价格战的爆发。 正如药品定价监督机构 ICER CEO 萨拉・埃蒙德所言，肥胖药市场正面临诸多 “首次” 挑战。从丙肝到肥胖药，医药巨头的定价博弈从未停止，而如何在疗效、价格与可及性之间找到平衡，仍是行业需要持续解答的难题。 参考来源：https://www.biospace.com/business/before-glp-1s-a-great-pricing-battle-played-out-in-hep-c-market 识别微信二维码，添加抗体圈小编，符合条件者即可加入抗体圈微信群！ 请注明：姓名+研究方向！ 本公众号所有转载文章系出于传递更多信息之目的，且明确注明来源和作者，不希望被转载的媒体或个人可与我们联系(cbplib@163.com)，我们将立即进行删除处理。所有文章仅代表作者观点，不代表本站立场。

iStock, SvetaZi The introduction of AbbVie’s hepatitis C drugs in 2014 forced Gilead’s hand in the fight for market dominance in hepatitis C. A similar dynamic is now playing out between Eli Lilly and Novo Nordisk in the obesity space, with some key differences. Almost 10 years before Novo Nordisk and Eli Lilly’s cutthroat battle for control of the obesity market, AbbVie and Gilead duked it out over a highly effective class of hepatitis C drugs. As Novo and Lilly’s drug prices come on full display in the deal announced at the White House earlier this month. This unprecedented moment, where Lilly and Novo are slashing the price of their GLP-1 drugs well before they have generic competition, had some experts looking back on the moment with Gilead and AbbVie—a same but different moment from the recent past. “It’s the closest analogy we have to this. But there’s some important differences,” Sarah Emond, CEO of drug pricing watchdog the Institute for Clinical and Economic Review (ICER), told BioSpace . So let’s go back to 2013. First on the scene in December of that year was Gilead with Sovaldi, which included the active ingredient sofosbuvir and showed high cure rates over a 12-week treatment course. The wholesale acquisition cost of the drug was $28,000 for a 28-pill bottle. “That was a situation where you had a $1,000 pill—$1,000 a day,” Morningstar analyst Karen Andersen remembered. (Gilead did offer an assistance program with a $5 co-pay for eligible patients.) Drug pricing How Effective Will TrumpRx and Other Direct-to-Consumer Drug Pricing Initiatives Be? With pricing pressures climbing, Pfizer, Eli Lilly and other major drugmakers are looking to sell their products directly to patients. Analysts are skeptical that these efforts, including those announced to much fanfare from the White House, will result in meaningful reductions in drug spending. November 12, 2025 · 11 min read · Tristan Manalac Read More The FDA approved a second Gilead hep C treatment just under a year later in October 2014 . Harvoni, a combination of sofosbuvir and ledipasvir, offered a shorter treatment time for patients with certain genotypes of the virus. Gilead did not announce the price at the time, but ICER said a 12-week course had a list price of $95,000. Gilead enjoyed wild market success—and blowback for the cost of the treatment. Then came AbbVie. AbbVie launched Viekira Pak months after Haravoni. “The minute you had a viable competitor—Gilead started seeing competition from AbbVie—that pricing went from . . . $80,000 or so to $20,000 for a cure,” Andersen said. In announcing the U.S. market approval of Viekira in December 2014, AbbVie noted the drug’s high cure rates and shorter duration of treatment. While a price was not named, Bloomberg News reported a list price of $83,319, a 12% discount to Gilead’s Harvoni. (Like Gilead, AbbVie offered patient assistance, promising access to Viekira Pak for just $5 a month.) Insurers quickly took note. A few days after the FDA’s greenlight, Express Scripts secured a discount to that price with AbbVie and offered to carry Viekira Pak over Harvoni, which would be dropped for most patients at the start of 2015. At the time, Express Scripts Chief Medical Officer Steve Miller noted that patients in France were paying $51,373 for Sovaldi, according to a report from FirstWord Pharma . Analysts projected $2.9 billion in first-year sales for Viekira Pak, which requires patients to take six pills a day instead of one. Gilead agreed to bring the price of Sovaldi and Harvoni down in February 2015, offering a 46% discount off the original list price. ICER revised its rating for the drugs to “high value” for most healthcare systems. Then-Gilead CEO John Milligan touted Harvoni’s superiority early on. “The market doesn’t think they are comparable. There’s a clear preference for Harvoni over the Viekira Pak,” Milligan said at a conference in June 2015. But trouble emerged in AbbVie’s franchise. One of Viekira Pak’s active ingredients, ribavirin, proved to be difficult for patients to tolerate. Common side effects included hemolytic anemia, itchiness, fatigue and upper respiratory symptoms. The ingredient was quickly recommended to be used only for the most severe cases of hep C . AbbVie updated the label for Viekira Pak in October 2015 to warn of liver risks and recommend closer patient monitoring. Meanwhile, the company kept working in the clinic on a better drug. AbbVie’s Mavyret, which dropped ribavirin in favor of a cocktail of an NS3/4A protease inhibitor glecaprevir and an NS5A inhibitor pibrentasvir, was approved in August 2017 . The drug, which rendered the virus undetectable in clinical trials, was developed with Enanta Pharmaceuticals . AbbVie listed the drug at $26,400 for an eight-week treatment. The drug decimated Gilead’s hep C sales, causing the company to lower its profit guidance for the franchise, according to a February 2018 report in Fierce Pharma . The price for Sovaldi was about $28,000 per month and Harvoni was $31,500, compared to Mavyret’s $13,500. The hep C franchise combined collected $3.7 billion, down from 9.1 billion the year prior, according to Gilead’s year-end 2018 earnings report. The company attributed the decline to lower average net selling price and lower volume of sales for Harvoni and other medicines in the portfolio “as a result of increased competition and lower patient starts.” By 2019, the company stopped reporting sales of the two drugs individually. AbbVie’s hep C franchise never reached anywhere near the heights of Gilead’s, with Mavyret peaking at $3.4 billion in 2018. Back to 2025 The hep C battle is the only time in recent memory that Andersen or Emond can remember price coming into play so early in a drug’s lifecycle. The typical path is for a branded medication to enjoy years of exclusive market success with a high price—unless, of course, a better rival drug comes along and supplants it. But typically, efficacy or some enhancement in the treatment paradigm is what changes the market, not price. These same dynamics are playing out right now between Novo and Lilly—two mega pharmas that aren’t strangers to mutual competition, Andersen said. But this time is different. Two weeks ago, both Novo and Lilly’s CEOs appeared at the White House to announce a drug pricing deal with President Donald Trump that would bring their GLP-1 medications down to around $350 per month. It wasn’t a huge change, as both companies have been offered direct-to-consumer (DTC) options for months that provide the drugs at a steep discount to the list prices. Lilly’s Zepbound initially had a list price of $1,059.87 per month when it launched at the end of 2023. Single-dose vials can now be purchased at Walmart through LillyDirect for $349 per month, according to a recent announcement . The current list price for Wegovy in the U.S. is $1,349.02 for a 28-day supply, according to Novo. But the manufacturer offers rebates that can bring down the cost to about $499 a month. As is typical for such DTC platforms, patients must pay out of pocket. While not all commercial insurance covers the weight loss medication, Novo says that through payers that do, patients may pay just $224 per month, or nothing at all. Emond said that the two markets are fairly similar, in that hep C and obesity are both public health priorities. Both market battles started with high list and net prices, with Novo enjoying first-entrant advantage early on. Even when Lilly entered the picture, the prices stayed high. .responsive-container { display: flex; flex-wrap: wrap; border: 1px solid #ededed; font-family: Helvetica, Arial, Sans-Serif; padding: 20px 20px 10px 20px; } .column-left { flex: 1; max-width: 45%; padding: 20px 20px 10px 20px; } .column-right { flex: 2; padding: 20px 20px 10px 20px; } @media (max-width: 768px) { .column-left, .column-right { max-width: 100%; flex: 100%; padding: 10px 0; } } Subscribe to BioPharm Executive! Market insights, trending business and policy stories for biopharma leaders hbspt.forms.create({ region: "na1", portalId: "4413123", formId: "7c139b3c-ff0b-44e0-bffe-f449801dca59", onFormSubmitted: function($form, data) { window.dataLayer = window.dataLayer || []; window.dataLayer.push({ 'event': 'GTMevent', 'event_name': 'newsletter_sign_up' }); } }); “Both drugs are wildly cost effective. And a similar thing happened with the hepatitis C drugs, as we saw competition come in,” Emond said. But with GLP-1s, both the U.S. government and private insurance companies are largely declining to cover treatment for the weight loss treatments, leading to a fast-moving consumer market where patients self-pay for access. Meanwhile, the pharmas have been contending with significant pressure from the Trump administration to lower prices across their portfolios, with the president particularly targeting the weight loss drugs. “For years they’ve been competing in diabetes and they’ve been competing in obesity. So there’s already in the backdrop that typical competition for them,” Andersen said. “But the more policy side of this, and just the lack of insurance coverage, I think, are the things that made this very primed for significant reform of the direct-to-consumer side and seeing these lower prices.” Hep C is also a one-time treatment that is potentially curative, whereas GLP-1s require long-term maintenance dosing. “These obesity medicines are for a chronic condition likely needing to be taken for a lifetime and so that represents a little bit different math when you think about budget impact,” Emond said. At ICER, he added, “that’s where we’re all spending our time, trying to think about how to introduce these drugs in an affordable way.” ICER has determined that the obesity drugs are cost-effective—a strong vote of confidence for any treatment in pharma. The problem is that the potential market is just so huge that affordability means something completely different when it comes to weight loss medications. “It’s not that they’re not priced to value—they are. It’s just that the number of eligible patients makes it really hard to introduce them in an affordable way,” Emond said. “We continue to just have a lot of firsts when it comes to the obesity medicines for us as a drug pricing ecosystem.”