Express Scripts, one of the largest pharmacy benefits managers in the United States, is assembling an anti-Sovaldi insurance coalition to try pushing Gilead out of the market for treating the hepatitis C virus (HCV), FiercePharma reports.

Sovaldi (sofosbuvir) is a breakthrough hep C treatment that the Food and Drug Administration approved in December 2013. But the price tag averages $84,000 per treatment, or nearly $1,000 per pill.

Express Scripts, which allocates reimbursement money to a huge proportion of U.S. private insurance markets, is urging insurers to refuse to cover Sovaldi as soon as competitors hit the market, perhaps as early as this fall.

Gilead argues that Sovaldi’s price tag is fair for insurers because the high cure rate will cut down on the expensive complications of hep C, such as cirrhosis and the need for liver transplants.

Insurers claim they won’t be able to cover the up-front cost. Since millions of people across the country already have the virus, analysts estimate that giving Sovaldi to every person living with HCV would cost upwards of $300 billion. That’s more than the United States currently spends on all prescription meds combined.

The Express Scripts plan hinges on the hope that upcoming treatments will start a price competition in the hepatitis C market. But if Gilead’s rivals don’t lower the costs of their new HCV drugs, then the efforts of the coalition could fail.

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