Source: Wikimedia Commons

An epic fight is under way in the world of hepatitis C. We've seen a couple of punches thrown just over the last few days. The latest occurred on Thursday with Anthem's (NYSE:ANTM) selection of Gilead Sciences' (NASDAQ:GILD) Harvoni as a primary treatment for patients with hepatitis C genotype 1, the most common strain of the disease.

With nearly every slugging match, there's at least one battered and bruised loser. Is that true in the brawl between Gilead and AbbVie (NYSE:ABBV)? In this case, there appear to be several winners and one loser -- maybe.

Of course, Gilead has emerged as the most recent winner. The deal with Anthem came on the heels of CVS Health's (NYSE:CVS) deal to exclusively offer Gilead's hep-C drugs. Those were two quick jabs in rapid succession.

AbbVie, however, is still a winner in my view. The big biotech scored points in December with its own arrangement with the nation's largest pharmacy benefits manager, or PBM, Express Scripts (NASDAQ:ESRX). AbbVie's move sent Gilead reeling -- at least temporarily.

It's worth noting that AbbVie's stock hasn't exactly caught on fire with the Express Scripts deal. That doesn't mean the company shouldn't be included on the winners' list, however. Striking a bargain with the giant PBM was a smart play that should benefit AbbVie over the long run.

Other winners stand out as well. Anthem is the largest provider of health insurance to businesses in the U.S. Gaining lower pricing for Harvoni will likely help the insurer win even more corporate business. Likewise, Express Scripts and CVS Health will both be able to bring lower hep-C drug prices to their respective customers. 

...And loser?
That leads us to one company that might appear to be the loser in the scuffle between AbbVie and Gilead: Catamaran Corporation (UNKNOWN:CTRX.DL). Catamaran ranks as the fourth largest PBM in the U.S. And -- at least so far -- Catamaran doesn't have a special deal with either of the hep-C drugmakers.

Source: Catamaran Corporation 

If things remain as they are, you might think that Catamaran could have a tough time going head-to-head against its larger rivals who can offer lower hep-C drug prices. But not everyone would agree with that assessment.

On Thursday, JPMorgan Chase analysts raised the target price for Catamaran from $54 to $56. Shares of the PBM jumped over 5% after the positive outlook. On the other hand, Morgan Stanley analysts downgraded Catamaran from "equal weight" rating to "underweight" rating earlier in the week. So is Catamaran poised to be a winner like JPMorgan thinks or a loser like Morgan Stanley suspects?

My take is that Catamaran should at least hold its own. The company just completed its acquisition of Salveo Specialty Pharmacy and launched specialty pharmacy business BriovaRx in 2012. Specialty drugs, including those that treat hepatitis C, are an attractive opportunity for Catamaran.

And don't be surprised if Catamaran doesn't forge a deal with AbbVie or Gilead. Even if the company doesn't negotiate pricing as low as Express Scripts or CVS Health, it can still emerge as a winner for the mid-size market that Catamaran particularly likes. 

Fighting on
While there has been a lot of commotion over the high prices of hepatitis C drugs, ultimately there should be plenty of winners in this huge market. The biotechs will win, of course, as they sell billions of dollars worth of their drugs. Payers will win because the total healthcare costs should be reduced over time as expensive transplants are avoided. PBM's will win as they help customers control the costs of the high-dollar drugs.

The biggest winners of all, though, are the patients who are cured from this chronic disease. The fights between AbbVie and Gilead and between Express Scripts, CVS Health, and Catamaran mean the most for those who have been in the fight against hepatitis C in the truest sense of the term.