

Three years ago, Gilead Sciences was generating record sales and profits on the back of its hepatitis C pills. Now, Gilead's medicines are playing second fiddle to a competitor, and the drug that started it all, Sovaldi, has been relegated to a footnote.
The big picture: Gilead's drugs were a major reason why pharmaceutical spending shot up in 2014 and 2015, as patients flocked to the high-priced pills that cure the disease for a vast majority of people. Sales have gone down considerably, due to competing drugs and restrictive insurance coverage, even though a large number of hepatitis C patients remain untreated.
Between the lines: AbbVie has been the leading hepatitis C drugmaker for 2 consecutive quarters, as its Mavyret medicine has outsold Gilead's options, led by Epclusa and Harvoni.
- Gilead is still projected to collect roughly $3 billion in sales this year from its hepatitis C drugs, but that's a far cry from when it was getting almost $5 billion per quarter from hepatitis C drugs in 2015.
- Merck remains far behind AbbVie and Gilead in the market, even though it cut the price of Zepatier by 60% last year.
What we're watching: Whether more state Medicaid programs follow Louisiana and adopt a subscription approach to purchasing hepatitis C medications.
Go deeper: Inmates with hepatitis C aren't getting the medicine.