(Bloomberg) — Express Scripts Holding Co. (Nasdaq:ESRX), which this year forced price concessions from makers of $1,000-a-day hepatitis C medicines, has set its sights on $37 billion in U.S. spending on cancer medications. Its goal is to start influencing the drugs’ costs as soon as next year.
Express Scripts is the country’s biggest manager of prescription drug benefits. However, its reach doesn’t extend to many injected or infused cancer drugs administered in doctors’ offices and hospitals, not dispensed in retail pharmacies. The St. Louis-based company’s ambition is to change that, including eventually for new drugs that trigger the body’s own immune system to attack tumors and can cost $150,000.
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“We want to be able to start influencing the market by 2016,” said Steve Miller, Express Scripts’ chief medical officer, in an interview at Bloomberg’s offices in New York. “We are accumulating all the keys to the puzzle to be able to do this.”
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In December, Express Scripts upended the pharmaceutical industry when it blocked Harvoni, a hepatitis C drug developed by Gilead Sciences Inc. (Nasdaq:GILD), from its main formulary, or list of covered medicines, in favor of a competing treatment from AbbVie Inc. (NYSE:ABBV).
Express Scripts got AbbVie’s drug at a discounted price, and the move ignited a back-and-forth price war between the drugmakers, which have offered discounts to other payers in return for coverage.
Express Scripts administers pharmacy benefits for about 85 million people in the U.S., and its main formulary covers 25 million of those.