The pharmacy benefit manager Express Scripts has announced that it will only reimburse for AbbVie’s hepatitis C virus regimen and not for HCV drugs from Gilead Sciences or Janssen for people with genotype 1 of the virus, The New York Times reports. Express Scripts, which serves 25 million people, has negotiated a lower price for AbbVie’s just-approved Viekira Pak regimen, apparently heralding a new era of pricing competition in the fast-changing hep C drug market. In addition, the company will agree to pay for Vikira Pak treatment for all HCV-positive people, not just those with advanced liver disease—big news, as many state Medicaid programs and prison systems have been restricting coverage.

With a list price of $83,319 for 12 weeks of therapy, Viekira Pak has comparable cure rates to Gilead’s new single-pill combination therapy, Harvoni (ledipasvir/sofosbuvir), which costs $94,500 for 12 weeks and was approved in October 2014. Both treatments are only approved for people with genotype 1 of the virus, who make up about 70 percent of the American HCV-positive population. An estimated half of people with genotype 1 may be able to take Harvoni for only eight weeks, however, which lowers the cost to $63,000. Then there are the two older treatments that were both approved in December 2013: Gilead’s Sovaldi (sofosbuvir), which has an $84,000 price tag for 12 weeks, and Janssen’s Olysio (simeprevir), which costs $66,360 for 12 weeks.

The exact discount Express Scripts secured is under wraps. However, Steve Miller, MD, the company’s chief medical officer, told The Times that the lowered price would come closer to those found in Europe, where Sovaldi can sell in the range of $50,000 to $70,000.

Viekira does have some downsides when measured against Harvoni in particular: The regimen requires taking three pills each day instead of one; and some will need to take it with ribavirin, which can cause side effects such as anemia. An upside is that AbbVie’s arrangement with Express Scripts stipulates that the cost will not double if 24 weeks of treatment instead of 12 are required, unlike other drugs on the market. Additionally, the pharmacy benefit manager will still reimburse for Sovaldi use among those who do not have genotype 1 of hep C, and those who are taking drugs other than Viekira Pak can continue to do so.

Express Scripts will also permit clinicians other than liver and infectious disease specialists to prescribe Viekira Pak.

To read the Times story, click here.