Pharmalot: WSJBy Ed SilvermanAug 7, 2014India has become the latest country where the Sovaldi hepatitis C treatment will be offered for $900 per patient. The move, which was reported by The Times of India, comes a few weeks after the manufacturer, Gilead Sciences GILD +0.66%, is making the medication available for the same price in Egypt. The pricing reflects an effort by Gilead to forestall the sort of criticism the pharmaceutical industry has often encountered when selling life-saving medicines in poorer countries, which have often complained bitterly that many of its citizens have been unable to afford some treatments. An advocacy group last year formally opposed a patent for Sovaldi in India, claiming the treatment is based on “old science” and, therefore, does not deserve patent protection. An Indian generic drug maker made a similar point recently in asking Indian officials to deny the patent. If they prevail, generic alternatives could become available at low prices.
“We have set three basic pricing tiers [based on a country’s per capita income and hepatitis C prevalence] that serve as the starting point for negotiations with national governments. The tiers are low-income, low middle-income and upper-middle income,” Gregg Alton, a Gilead executive vice president for corporate and medical affairs, tells the paper. Such decisions, however, have further fed a controversy in the U.S., where Sovaldi costs $84,000 for the same 12-week regimen and has become a proxy for a growing national debate over the rising cost of prescription drugs.
The U.S. price tag has prompted objections from insurers, state Medicaid programs and politicians, among others, who complain the cost for Sovaldi will bust budgets as more hepatitis C sufferers are diagnosed and seek treatment. Gilead and its supporters say this argument is, effectively, short sighted by noting that Sovaldi can cure nine of 10 patients, many of whom would require more expensive treatment over a protracted period. In other words, society saves money in the long run…
Brody also had this to say about the drug:
Sovaldi, the recently announced $1000 pill for hepatitis C. Hepatitis C does affect a lot of people, including relatively affluent people in developed countries. As we noted previously, though, the majority of people infected with hepatitis C will never have serious medical repercussion from it. Small proportions of patients will eventually develop severe liver disease, including cirrhosis, liver failure, and liver cancer, and may die from the disease. (See the report by the Center for Evidence Based Policy). Yet the treatment is being promoted for all patients with hepatitis C, most of whom could not benefit from treatment. Furthermore, the evidence that treatment will actually prevent bad clinical outcomes, cirrhosis, liver failure, liver cancer, and premature death, is weak (look here). Yet considerable money was devoted to developing multiple hepatitis C treatments, with the expectation that huge amounts of money could be made from selling them.
This is just part of the greater drive for profits in medicine per this link:
http://www.doconomics.com/blog/?p=4575
In my community hospitals have been buying private doctor’s practices for a number of years and the shock to the patient is when they receive a bill for a hospital based procedure performed at the doctor’s office. No warning, but a massive bill with a massive co-pay.
The pharma corporate mentality has infected all of medicine with partial truths and even lies constituting good medical practice. We had to suffer through an ad campaign that made family of cancer survivors also cancer survivors, with the need to contribute to cancer research and to be screened.
Popular was the hospital run PSA screening where very few if any cancer was found, but the follow on testing constituted untold dollars to the hospitals sponsoring these events.
Drugs and guidelines are based on the self interest of those involved, not on patient need or anything approaching science. Push back on the part of medical societies is always met with: Yes, but I want what is best for my patient and cost is not a factor.
Like a dog chasing their tail we have seen those trying to control cost put forth new guidelines only to see those guidelines perverted and used to generate additional revenue, producing a system with twice the cost of any in the world with less than optimal outcomes
Steve Lucas