25 ms·

Non-profit’s $300 hepatitis C cure as effective as $84k alternative

874 points by lnguyen 9y ago

StudentStuff 9y ago
This is great for public health, leaving people with untreated diseases due to artificially high drug prices is literally killing people needlessly.
- firstplacelast 9y ago
  As someone that works in biotech and has worked in pharma ocassionally, we need to charge more. I know this sounds terrible, but I make 1/5 of what an average engineer does at FaceBook and I live in the same city. So get fucked and die or pay.
  - Insanity 9y ago
    The drug costing more does not equate to you earning more, it means the company you work for earns more. Which might or might not translate to you earning more money, but the people in the chain 'above' you will each want a slightly larger share as well. Plus why should they pay _you_ more when they can find people willing to work for the industry average?
  - tvelichkov 9y ago
    I'm pretty sure that even if that thing costs a million, your salary will not increase.
  - rf15 9y ago
    You're not going to see a raise if drugs get more expensive; the company is only interested in paying you the minimal possible amount and giving everything else to high-ranking shareholders. This is a shareholder/roi-optimising economy, I'm afraid you are not in any position for anything.
  - consp 9y ago
    Quite strange for me, in Europe it's the other way around. Biotech engineers earn about double of any other type of engineer, software, mechanical or otherwise. And what everyone else already said: raising prices will almost never result in the engineers getting more money.
    - gieksosz 9y ago
      I worked in Biotech in western Europe for a few years before switching to pure software work. Biotech sector is very small, few openings and all of it concentrated in just a few parts of the world. Money is slightly lower than generic webapp dev work (at least at the companies I know of), probably because universities are pumping out a huge oversupply of viable candidates with PhD/MSc (majority of them quit Biotech / never find related work).
firefoxd 9y ago
One day, we will look back and not understand how this was even possible. You come up with a cure for something and you make the price so high that it is cheaper to die from the disease.
- StudentStuff 9y ago
  Its late stage capitalism at its finest. Profiting off mass suffering is to be applauded and rewarded, not considered immoral and illegal. We would rather let each other die of treatable conditions than have slightly lower profit.
  - TomMarius 9y ago
    Regulation has nothing to do with capitalism. Capitalists (as in people believing in the free market) are actually opposed to what you're describing. What this non-profit did would happen immediately if there was no government to shut it down because there are high margins and so it's very desirable to enter the market with a lower price - and also charity.
    - xyzzyz 9y ago
      If there was no government to shut down the nonprofit, the company wouldn’t have spent billions to develop the cure in the first place. Why would you do that, if anyone could just copy your work and profit for themselves?
      - TomMarius 9y ago
        As a charity, for example. The market would find a way, I'm sure. This is already well thought out, if you're truly interested, I recommend this article by a well known economist: https://mises.org/library/pharmaceutical-prices-patents-and-fda https://mises.org/library/pharmaceutical-prices-patents-and-... And also this one: https://mises.org/library/advancing-pharmaceutical-and-medical-technology-does-not-depend-patents https://mises.org/library/advancing-pharmaceutical-and-medic... It's in no one's interest to have people dying instead of buying and selling services.
deleted 9y ago
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einselbst 9y ago
Great info about this very topic from a recent 'Blätter für deutsche und Internationale Politik' Magazin. https://www.blaetter.de/archiv/jahrgaenge/2018/februar/gewinn-vor-gesundheit https://www.blaetter.de/archiv/jahrgaenge/2018/februar/gewin... Unfortunately in german: I have no time to translate but will give this one info from it: They calculated that the costs for a 3-month-treatment would be 75 Dollars including profit and logistics. Eindrucksvoll zeigt dies das Beispiel des Medikaments Sofosbuvir (Sovaldi®) zur Behandlung der chronischen Hepatitis C, das Ende 2013 in den USA erstmalig zugelassen wurde und hochwirksam ist. Hepatitis C ist eine virusbedingte Leberentzündung, die durch Blut und Blutprodukte übertragen wird. Weltweit sind etwa 150 Millionen Menschen infiziert. Bei den Patienten entwickelt sich mit den Jahren eine Leberzirrhose, die zu Leberversagen und Leberkrebs führen kann. Die Zulassung von Sofosbuvir stellte einen Durchbruch für die Behandlung von Hepatitis C dar: Zuvor gab es nur geringe Heilungschancen und die bisher eingesetzten Medikamente zeigen starke Nebenwirkungen. Mit dem neuen Präparat können die meisten Infizierten binnen zwölf Wochen vollständig geheilt werden. Im November 2011 übernahm der US-Pharmakonzern Gilead in einem Bieterwettbewerb für 11,4 Mrd. US Dollar bei einer jährlichen Gewinnerwartung von 20 Mrd. Dollar das Start-up Pharmasset, das den Hepatitis-C-Wirkstoff entwickelt hatte. Pharmasset hatte für die Forschung bis dahin 188 Mio. US-Dollar ausgegeben und 2012 den Preis für die Behandlungsphase mit Sofosbuvir auf 33 000 Dollar berechnet. Gilead investierte zwischen 2012 und 2014 noch einmal 880 Mio. Dollar für klinische Studien bis zur Markteinführung Anfang 2014. Inzwischen macht Gilead mit Sofosbuvir 55 Prozent Gewinn pro Jahr. Zum Vergleich: Der Gewinn der größeren US-Pharmakonzerne lag laut der „Forbes“-Liste der größten US-Unternehmen in den Jahren 2005 bis 2015 im Durchschnitt bei 17,44 Prozent, jener der anderen Industrieunternehmen bei 4,34 Prozent im Jahr. Der Wert der Gilead-Aktie hat sich seit dem Aufkauf von Pharmasset in 2011 verfünffacht. Während unter einer sogenannten Zwangslizenz – also einer Lizenzvergabe, die anderen Herstellern die Produktion und Vermarktung gegen eine angemessene Gebühr erlaubt – ein Herstellerpreis von 75 Euro für eine dreimonatige Behandlung inklusive Vertrieb und Gewinn möglich wäre, lag der Preis für eine achtwöchige Behandlung in den USA tatsächlich zwischen 84 000 und 168 000 US-Dollar.[11] Damit hatte Gilead die Übernahmekosten, mit denen es auch die hohen Kosten für die Therapie begründete, in nur einem Jahr weitgehend refinanziert. Der Markteinführungspreis von Sofosbuvir in Deutschland betrug 60 000 Euro, der schließlich verhandelte und von den Krankenkassen erstattete Preis nach einem Jahr bei etwa 45 000 Euro pro Behandlungsphase. In der Bundesrepublik sind von Hepatitis C 400 000 bis 500 000 Menschen betroffen, etwa 300 000 gelten als behandlungsbedürftig. Würden alle mit Sofosbuvir behandelt, entstünden Kosten von 13,5 Mrd. Euro. Das entspricht einem Drittel der gesamten Arzneimittelausgaben der gesetzlichen Krankenkassen im Jahr 2015. Die Aufwendungen der Unternehmen zeigen, dass diese nicht auf die hohen Preise angewiesen sind, um die Entwicklung der Medikamente zu refinanzieren: Gerade die großen Unternehmen geben oft doppelt so viel für Marketing aus wie für Forschung und Entwicklung. Außerdem machen sie 70 Prozent ihres Umsatzes mit Produkten, die von anderen Firmen – oft kleineren Start-ups – entwickelt wurden, also mit solchen, bei denen sie selbst keine Entwicklungskosten hatten.[12] Rund drei Viertel der Umsatzrendite der größten 20 Pharmaunternehmen gehen in die Auszahlung von Dividenden und den Rückkauf von Aktien, um den Aktienwert zu steigern. 16 Prozent werden in Übernahmen und Fusionen investiert und 10 Prozent in Anlagegüter und Sachanlagen.[13] Zudem versuchen die Pharmaunternehmen, durch Übernahmen und Zusammenschlüsse ihre Forschungskosten zu senken oder Steuern zu sparen – etwa indem sie Firmen in Ländern mit niedrigen Steuern wie Irland aufkaufen und ihren Unternehmenssitz formell dorthin verlegen. Ihre Innovation und Forschungsproduktivität erhöht sich dadurch nicht. Schließlich fließt auch viel Geld in die Lobbyarbeit der multinationalen Konzerne – zu „Big Pharma“ zählen Unternehmen wie Jonson & Jonson, Pfizer, Novartis, und Roche. Sie geben in den USA mehr für Lobbying aus als alle anderen Branchen. Pharmageld fließt also hauptsächlich in Marketing und Maßnahmen, mit denen der Monopolstatus verteidigt und ausgedehnt wird – und nicht in die Entwicklung neuer, möglichst wirksamer Medikamente.
tim333 9y ago
Now look forward to its use being blocked for a decade or two by FDA regulations and lawsuits.
avar 9y ago
The latest episode of Econtalk "Vincent Rajkumar on the High Price of Cancer Drugs" is relevant to this subject: http://www.econtalk.org/archives/2018/04/vincent_rajkuma.html http://www.econtalk.org/archives/2018/04/vincent_rajkuma.htm... It discusses structural issues relating to why drugs are so expensive (mainly in the US). Some of it's regulatory (e.g. Medicare not being allowed to negotiate drug prices), or there being no ceiling on prices related to efficacy as in many other countries. But some of it's because nobody in the system seems to have a real incentive to reduce costs, even when the benefits are worth it. E.g. an example that's mentioned is that doctors will usually describe the latest brand medicine that's outrageously expensive, instead of a generic that's cheap and statistically almost exactly the same thing when it comes to efficacy.
- deleted 9y ago
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- Aloha 9y ago
  In every US state that I know of - a generic will be substituted for a brand name drug unless the doctor specifically specifies that it should not be.
  - avar 9y ago
    I was unclear, the podcast discusses cases where there's no generic version of the latest drug, and the latest drug is marginally more effective than whatever the latest generic is. So the generic just doesn't get considered, even though it would be suitable for the patient at much lower costs. This is unrelated to the situation you're describing.
    - Aloha 9y ago
      Having a medical condition that requires long term medication maintenance - every single doctor I've had is very well aware of what is a generic and what is not - and tends to prescribe a generic, as they are often an ER version of the regular med, or a compounded version of two medications that can be taken separately.
yread 9y ago
Similar story: 'Coffee filter' helps make new cancer drug Z-endoxifen 1000 times cheaper https://www.sciencedaily.com/releases/2018/04/180405120401.htm https://www.sciencedaily.com/releases/2018/04/180405120401.h...
kyaghmour 9y ago
The price difference is so staggering that it'll just be cheaper to buy a plane ticket to the countries where the cheap one is available and take it there; especially since some countries (Egypt for instance) don't necessarily require a doctor's prescription to allow you to buy some medication from the pharmacy.
- bvinc 9y ago
  I actually know a good friend that had Hep C that did exactly that. He flew to Egypt and walked into a pharmacy and bought it. I forget how much he paid, but it was closer to $1,000 instead of $84,000.
solidangle 9y ago
These price comparisons are almost always disingenuous. One price only includes the cost to produce the medicine, and the other also includes years of R&D, 10+ years of trials, marketing, and distribution. Sure, the $84000 probably still includes a hefty profit margin, but with all those extra costs the $300 medicine becomes a lot more expensive.
- yardie 9y ago
  I’m not buying it. Nothing justifies a 300x markup for drugs. State and federal grants cover most of the research. Drug companies only enter the picture near the late stage and only if it’s a viable project.
  - chimeracoder 9y ago
    > State and federal grants cover most of the research. That's straight up not true. Most of the money spent on research is obtained directly through pharmaceutical sales in the US, and a large chunk of the rest is obtained indirectly in the same manner.
    - fricat1ve 9y ago
      You keep stating this as if it were a fact, but did it occur to you that delineating what research spending in fact contributed is complex? Medicine is perhaps the industry that most exemplifies one with large confluent streams of money from public, private, and charitable sources involved at different levels of training, research, and practice.
      - chimeracoder 9y ago
        > You keep stating this as if it were a fact, but did it occur to you that delineating what research spending in fact contributed is complex? Yes, as someone who's actually done this sort of tracking and research extensively, it has, in fact, occurred to me that it is a complex task.
- 9y ago
jlebrech 9y ago
Companies should be able to charge what they want. But also other companies should be able to copy the drugs (shorter patents), especially non-profits. Maybe lab should have to second source production to others and then compete with each other on price.
soVeryTired 9y ago
So did GDP just go up or down?
dfee 9y ago
I worked with a hepatologist once who donated his services to low-income patients with hep c. Encouraged by his selfless act, I called him to learn more about how our services could help him (he was asking for a discount). Well, it turns out that while his services were donated, he also owned a pharmacy and stood to make a lot more by using the donated time as what we might call a “customer acquisition cost”. I would be surprised if he continues treating patients if the payout for treatment really goes down 30 fold. For what it’s worth, that’s a pretty typical physician I’ve worked with and I’ve worked with hundreds. I don’t know why I expect more from physicians, but I do and they usually let me down.
- loceng 9y ago
  Money as an incentive allows a lot of bad behaviour to exist, and regulating and enforcement bodies don't seem to have proper processes for self-regulation - which would catch this kind of conflict of interest, as one example.
- neuro_imager 9y ago
  I'm guessing you're in the US where this type of behaviour is typical. Fortunately that is not the case in many other parts of the world where incentives are not as perverse. (physician here)
  - chimeracoder 9y ago
    > Fortunately that is not the case in many other parts of the world where incentives are not as perverse. Incentives absolutely are structurally perverse in other parts of the world. They're just perverse in different ways, which often mask the effects to patients.
perseusprime11 9y ago
$300 still sounds good money for most folk to afford. When can we make these free?
- zaroth 9y ago
  I think what you’re trying to ask is, “Who else can we get to pay for this?” I’m sure you’re not thinking FDA approved drugs will literally rain from the sky and magically fall into your mouth curing you of this horrible deadly disease...
- chapium 9y ago
  It depends on your country’s politics of course. What level of care do you want to be publicly funded? I have my doubts that the price can remain this low even if the nonprofit controls the IP. If that IP changes ownership or if the nonprofit prices the drug closer to the market value it will likely change. Edit: Also, the price cannot be contained on the fair market unless competitors who can produce the drug are allowed to exist.
chiefalchemist 9y ago
"Harvoni now costs about $48,000 for a 12-week course in Malaysia and $12,000 in Chile. Gilead’s previous Sovaldi treatment cost $1,000 a pill, or $84,000 over 12 weeks. Prices vary around the world and tend to be highest in the US." I can understand slight differences, but this is disturbing. That said, does anyone know the effects on (US) taxes if a drug company lists a cost as $X but has various programs to sell that product at some fraction of $X? Between insurance and such, does anyone really pay full price? So is there some (unknown?) incentive for companies to inflate the list price?
- opencl 9y ago
  How do you think everyone gets it below list price? The insurance companies are paying the difference. Medicaid pays 85% of list price.
  - chiefalchemist 9y ago
    I presume the hospitals and insurance companies negotiate "volume discounts" or similar, effective paying less (but call it whatever you want.) For example, a hospital stay. The insurance company would pay $Y and that's accepted by the hospital - no questions asked. On the other hand, you, without insurance, would pay the "list price" which isn't $Y but $Y+ $Z. This type of price "confusion" only benefits those with the resources and desire to exploit it.
refurb 9y ago
Of course it's cheaper if you ignore all the R&D costs. A good analogy would be software. If I copy a DVD that has AutoCAD on it, I could go out and claim "I'm only charging $5 for my software vs those greedy manufacturers charging $500".
- slim 9y ago
  So when they recover the cost of R&D they should align with the the cheaper price?
  - refurb 9y ago
    Would you make an investment if there was a risk you lost it all, but the best you could expect would be all your money back, not a dime more? Probably not.
  - DangerousPie 9y ago
    That's exactly what the limited time period for patent protection is supposed to ensure, isn't it?
shadowtree 9y ago
Great news, the market is working. I don't get the vitriol in the comments, tech plays outs exactly the same. What once cost millions in a data center is now pennies in AWS. Pharco is a normal for-profit pharma company and attacking an established market. Good for them. This hasn't gone through FDA approval yet though, so this is a long time off and a lot of things can happen on the way (nasty side effects killing people, etc). Isn't it great that humanity found a way to cure Hep-C?
Proven 9y ago
Another proof that state “managed” healthcare is unnecessary
exabrial 9y ago
If the new company did the r&d costs then great! That'll force competition into the market and drive prices down. It they stole the IP I'm very sad to see that. Drugs are incredibly expensive to prove they work and they're safe. If we want to continue to receive new cures, we have to let drug companies recoup their costs. The drug patent process definitely needs reform. Eventually these drugs ought to become public domain as everything does so we can advance humanity. I feel a lot better patent system for drugs would be 10-15 years after the drug is approved, with a capped provisional during the process. I feel like the strikes a balance between allowing companies to safely research and protect their cost but also will allow generics to enter the market eventually.
slim 9y ago
When you're ill, you have no choice but buying medication whatever the price asked. $84000 represents more than an entire life of salary in Africa. So essentially giving a monopoly on medication to a company is equivalent to giving them slaves
- owlmirror 9y ago
  The absurdity of intellectual property. Artificially inducing scarcity with state violence
refurb 9y ago
I'm a little confused. The "new" drug is combination treatment of two hepatitis C tablets, ravidasvir (a new drug) and sofosbuvir. Ravidasvir is novel, but sofosbuvir is the active ingredient in Sovaldi and Gilead has IP protection on it. How do they plan to get around that? The article hints they will work with an Egyptian company to produce it, but Gilead aleady offers Sovaldi for $900 in Egypt. Do they think the Egyptian gov't will turn a blind eye to violating the IP?
- philipkglass 9y ago
  Do they think the Egyptian gov't will turn a blind eye to violating the IP? I wouldn't be very surprised if they do. Egypt doesn't have powerful domestic IP-reliant industries lobbying for the enforcement of IP. No doubt there are international obligations of some sort, but the benefit of "slash costs for curing a serious disease" is a lot more concrete than the penalty of "the country could face a protracted legal case." It's happened before, with e.g. antiretroviral drugs for HIV in South Africa. Ultimately the pharmaceutical companies backed down, both because they had limited material leverage and because "trying to make poor countries pay more for medicine" is judged in the court of public opinion.
  - refurb 9y ago
    But the Egyptian gov't already entered into a deal with Gilead to sell Sovaldi for only $900. I assume that was negotiated in good faith. If that hadn't happened I would agree that the Egyptian gov't could probably care less if someone broke the patent.
    - philipkglass 9y ago
      Saving an additional $600 per patient is significant for a country as poor as Egypt. The existence of an even cheaper alternative strengthens the Egyptian government's negotiating position for agreements going forward. Prices may be re-negotiated further downward in light of this new development. As a rough analogy: consider the effect of sci-hub on recent negotiations between universities subscribing to academic journals and the journals' publishers. Even if the universities do not openly embrace/endorse sci-hub, the existence of an unlicensed near-substitute for the licensed product has strengthened the negotiating position of the universities.
chrisweekly 9y ago
I had to hunt for the article URL from the linked page, so c/p the actual article URL here: https://www.theguardian.com/science/2018/apr/12/non-profits-300-hepatitis-c-cure-as-effective-as-84000-alternative https://www.theguardian.com/science/2018/apr/12/non-profits-...
chris_va 9y ago
People always get really upset with drug pricing, which makes for great headlines but not for rational decision making. In 2030, would we as a society rather have a generic, cheap, openly available HepC cure or not? That is the question you need to ask, and I don't think anyone would say no to that. The $84K drug will fall off patent by then, which means the system we currently have, flawed as it is, will produce that outcome. It doesn't cost $84,000 to manufacture that drug compound. That $300 one even has the expensive drug formulated in it! The $84,000 covers the cost of developing the drug, along with the 56/57 other drugs that generally fail for every one that hits the market, along with a profit incentive to run a pharmacuetical company in the first place. And yes, it's grossly unfair for the patients currently requiring expensive treatment, though solving that through insurance is almost certainly a better idea than regulating prices. If you start regulating drug prices, as have many other countries outside of the US, you disincentivize development. If there is a better way to create cures, that would be wonderful, and I think we would all welcome suggestions. However, there is a reason the US invents the majority of the world's pharmaceuticals. Nothing to date (everything from regulating prices aggressively to prolifigate government spending projects) has worked as well as what we have now for long term results.
- systems 9y ago
  yes there is, and its called public finance medicine, and health care, in my opinion, seem to fall nicely in that category you as someone who is not infected with the hepatitis C virus, would benefit from others getting cured from it, to reduce the possibility of you catching it and this is just one example and to be clear, i am not saying, that all health care should be exclusively public i am just saying that public finance of not for profit organization working on creating medicine, should be an option
  - geezerjay 9y ago
    > yes there is, and its called public finance > > medicine, and health care, in my opinion, seem to fall nicely in that category Then get your government institutions to spend your taxes to do the legwork. Meanwhile, don't hinder progress by barring everyone else from doing the job your state is incapable of doing or doesn't want to do.
bigjimslade 9y ago
Competition drives prices down? Bloated, protectionist government regulations drive prices up? Wow! Stop the presses! This same story in umpteen other contexts has been written time and time and time again, throughout modern history. Get government out of the way. Let people put themselves to work in ways they feel most capable, and watch innovation happen, cost effectively, and to the benefit of mankind! What's old is new again.
greeneggs 9y ago
I would also like to recommend this Nature article, from August 2016, on the same Drugs for Neglected Diseases initiative (DNDi) discussed here. "Busting the billion-dollar myth: how to slash the cost of drug development" https://www.nature.com/news/busting-the-billion-dollar-myth-how-to-slash-the-cost-of-drug-development-1.20469 https://www.nature.com/news/busting-the-billion-dollar-myth-... > In just over a decade, the group has earned approval for six treatments, tackling sleeping sickness, malaria, Chagas’ disease and a form of leishmaniasis called kala-azar. And it has put another 26 drugs into development. It has done this with US$290 million — about one-quarter of what a typical pharmaceutical company would spend to develop just one drug. … In that vein, the DNDi has started research on alternatives to pricey drugs for hepatitis C…
- chimeracoder 9y ago
  Not to discount the significance of providing new treatments for things like malaria and sleeping sickness, but that's a pretty different category of problem altogether. The model described in that article is aimed at solving a different issue: providing medications for treating illnesses that are largely (though not exclusively) found in the developing world, and for which there is little investment from existing pharmaceutical R&D centers[0]. By contrast, Hepatitis C is the most deadly infectious disease in the US (and is comparably bad in Europe - arguably worse, actually due to inferior treatment options at the moment compared to the US). The cure for Hepatitis C came from a US-based company, out of research conducted on US patients and funded largely by the US pharmaceutical market. You wouldn't see groups like the DNDi tackling that kind of work, because they have vastly fewer resources than larger players do, and they ultimately wouldn't be able to compete, nor would they be able to establish distribution in the markets where they would need to have an impact[1]. Now that chronic Hepatitis C is a curable[2] disease, it's not surprising that other players will focus on providing cheaper alternatives to the treatment course, but again, that's a different problem from what the large pharmaceutical companies in the US and Europe solve. [0] The US is the largest of these, producing half of the world's R&D medical and pharmaceutical research, and Europe is another hub. China and India are the fastest growing, but have only been players on this scale in the last few years. [1] Producing the medication is, in some ways, the "easy" part - actually ensuring that it reaches the patients who need it is the really difficult part, and honestly the more impressive aspect of DNDi's sort of work. [2] Expensive, but curable
RcouF1uZ4gsC 9y ago
That is awesome. If non-profits can research and get a drug approved, they should be able to charge what they want. If for profits can research and get a drug approved, they should be able to charge what they want.
cowsandmilk 9y ago
My immediate question was "how are they getting sofosbuvir for $300?" That is literally Sovaldi and one of the components of Harvoni, which is what the article is comparing this to? Well, they are getting it that cheap because Gilead (the company selling HCV drugs for $84k in the US) licensed it as a generic for sale for this purpose[1]. So, no, this nonprofit didn't discover some cure out of nowhere, they created a combination therapy that uses one of the components of the $84K drug that is available inexpensively due to the owner of the $84k drug licensing that component for generic manufacture in that area of the world. [1] https://in.reuters.com/article/gilead-sciences-india/gilead-licenses-hepatitis-c-drug-to-cipla-ranbaxy-five-others-idINKBN0HA0TI20140915 https://in.reuters.com/article/gilead-sciences-india/gilead-...
- mjevans 9y ago
  I am curious about the age of that particular component (and skimming the linked article didn't seem like a detailed read would reveal anything of substantive detail). Maybe the modern expensive pre-packaged mixer of drugs is an attempt at re-patenting the actually effective and already existing drug and keeping generics (which could be manually prescribed with the other beneficial ingredients as separate medications) off the market.
  - aaavl2821 9y ago
    The components of the drugs are individually not generic and very expensive in the US. Sofusbuvir was discovered in 2007 Sofusbuvir is combined with other drugs (specifically ledipasvir) because it improves cure rates. Because the individual components are still on patent, prescribing each individually would cost more than prescribing the combo
- aaavl2821 9y ago
  From what I understand, Gilead and many other companies do provide some meds at cost to countries that don't have a system to pay for high priced drugs, especially if they are important drugs for large groups of sick patients Part of this is a corporate social responsibility thing, but part of it is because many of these drugs are purchased and distributed by entities that sometimes cut and dilute expensive drugs and resell them. This hurts patients and tarnishes the brand of the company. Selling their products at cost removes this incentive and allows patients to access the medicines in their unadulterated form So the pharma companies incentives aren't entirely altruistic but it helps patients in the end
lcfcjs 9y ago
Only in America could people get away with charging $84k as a cure FOR ANYTHING.
itissid 9y ago
Here is a thought, for those who have insurance. The insurance company can just give you an all expenses paid 12 business class trips (one per week @~3000$ a pop on the web and much cheaper if purchased in bulk) to go to Malaysia and get the 300$ treatment along with hotel stay for a day or two. And It would still be cheaper by 50%...
Rotdhizon 9y ago
I wonder how long it will be before this non-profit is bought out by a multi-billion dollar pharmaceutical company and that drug price magically skyrockets.
liragg 9y ago
I was about to take Cruise Ship Management in school last year. But unfortunately, when I received the result in hepatitis b test, it was positive. I don't know where I got this. I've never experienced having sex with any man or boyfriend. I was so disappointed at that time. But then again, it is never the end of the world. I repeated the test in a well-known hospital. But, it came back positive again. Early this year i purchase Hepatitis B herbal remedy online from BEST HEALTH HERBAL CENTRE. They told me i will be negative after 4-5 weeks of usage of their Hepatitis B herbal remedy, which i believed and have faith. After 5 weeks of usage, I did another test my HBsAg came negative in routine checkup, so I have done all investigations for hepatitis B. My test reports are HBsAg negative 0.04 on 22/02/2018. I will never stop telling the world about BEST HEALTH HERBAL CENTRE good work in human life ..
liragg 9y ago
HERBAL I was about to take Cruise Ship Management in school last year. But unfortunately, when I received the result in hepatitis b test, it was positive. I don't know where I got this. I've never experienced having sex with any man or boyfriend. I was so disappointed at that time. But then again, it is never the end of the world. I repeated the test in a well-known hospital. But, it came back positive again. Early this year i purchase Hepatitis B herbal remedy online from BEST HEALTH HERBAL CENTRE. They told me i will be negative after 4-5 weeks of usage of their Hepatitis B herbal remedy, which i believed and have faith. After 5 weeks of usage, I did another test my HBsAg came negative in routine checkup, so I have done all investigations for hepatitis B. My test reports are HBsAg negative 0.04 on 22/02/2018. I will never stop telling the world about BEST HEALTH HERBAL CENTRE good work in human life ..

874 points by lnguyen 9y ago

This is great for public health, leaving people with untreated diseases due to artificially high drug prices is literally killing people needlessly.

firstplacelast 9y ago
As someone that works in biotech and has worked in pharma ocassionally, we need to charge more. I know this sounds terrible, but I make 1/5 of what an average engineer does at FaceBook and I live in the same city. So get fucked and die or pay.
- Insanity 9y ago
  The drug costing more does not equate to you earning more, it means the company you work for earns more. Which might or might not translate to you earning more money, but the people in the chain 'above' you will each want a slightly larger share as well. Plus why should they pay _you_ more when they can find people willing to work for the industry average?
- tvelichkov 9y ago
  I'm pretty sure that even if that thing costs a million, your salary will not increase.
- rf15 9y ago
  You're not going to see a raise if drugs get more expensive; the company is only interested in paying you the minimal possible amount and giving everything else to high-ranking shareholders. This is a shareholder/roi-optimising economy, I'm afraid you are not in any position for anything.
- consp 9y ago
  Quite strange for me, in Europe it's the other way around. Biotech engineers earn about double of any other type of engineer, software, mechanical or otherwise. And what everyone else already said: raising prices will almost never result in the engineers getting more money.
  - gieksosz 9y ago
    I worked in Biotech in western Europe for a few years before switching to pure software work. Biotech sector is very small, few openings and all of it concentrated in just a few parts of the world. Money is slightly lower than generic webapp dev work (at least at the companies I know of), probably because universities are pumping out a huge oversupply of viable candidates with PhD/MSc (majority of them quit Biotech / never find related work).

firefoxd 9y ago

One day, we will look back and not understand how this was even possible. You come up with a cure for something and you make the price so high that it is cheaper to die from the disease.

StudentStuff 9y ago
Its late stage capitalism at its finest. Profiting off mass suffering is to be applauded and rewarded, not considered immoral and illegal. We would rather let each other die of treatable conditions than have slightly lower profit.
- TomMarius 9y ago
  Regulation has nothing to do with capitalism. Capitalists (as in people believing in the free market) are actually opposed to what you're describing. What this non-profit did would happen immediately if there was no government to shut it down because there are high margins and so it's very desirable to enter the market with a lower price - and also charity.
  - xyzzyz 9y ago
    If there was no government to shut down the nonprofit, the company wouldn’t have spent billions to develop the cure in the first place. Why would you do that, if anyone could just copy your work and profit for themselves?
    - TomMarius 9y ago
      As a charity, for example. The market would find a way, I'm sure. This is already well thought out, if you're truly interested, I recommend this article by a well known economist: https://mises.org/library/pharmaceutical-prices-patents-and-fda https://mises.org/library/pharmaceutical-prices-patents-and-... And also this one: https://mises.org/library/advancing-pharmaceutical-and-medical-technology-does-not-depend-patents https://mises.org/library/advancing-pharmaceutical-and-medic... It's in no one's interest to have people dying instead of buying and selling services.

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einselbst 9y ago

Great info about this very topic from a recent 'Blätter für deutsche und Internationale Politik' Magazin. https://www.blaetter.de/archiv/jahrgaenge/2018/februar/gewinn-vor-gesundheit https://www.blaetter.de/archiv/jahrgaenge/2018/februar/gewin... Unfortunately in german: I have no time to translate but will give this one info from it: They calculated that the costs for a 3-month-treatment would be 75 Dollars including profit and logistics. Eindrucksvoll zeigt dies das Beispiel des Medikaments Sofosbuvir (Sovaldi®) zur Behandlung der chronischen Hepatitis C, das Ende 2013 in den USA erstmalig zugelassen wurde und hochwirksam ist. Hepatitis C ist eine virusbedingte Leberentzündung, die durch Blut und Blutprodukte übertragen wird. Weltweit sind etwa 150 Millionen Menschen infiziert. Bei den Patienten entwickelt sich mit den Jahren eine Leberzirrhose, die zu Leberversagen und Leberkrebs führen kann. Die Zulassung von Sofosbuvir stellte einen Durchbruch für die Behandlung von Hepatitis C dar: Zuvor gab es nur geringe Heilungschancen und die bisher eingesetzten Medikamente zeigen starke Nebenwirkungen. Mit dem neuen Präparat können die meisten Infizierten binnen zwölf Wochen vollständig geheilt werden. Im November 2011 übernahm der US-Pharmakonzern Gilead in einem Bieterwettbewerb für 11,4 Mrd. US Dollar bei einer jährlichen Gewinnerwartung von 20 Mrd. Dollar das Start-up Pharmasset, das den Hepatitis-C-Wirkstoff entwickelt hatte. Pharmasset hatte für die Forschung bis dahin 188 Mio. US-Dollar ausgegeben und 2012 den Preis für die Behandlungsphase mit Sofosbuvir auf 33 000 Dollar berechnet. Gilead investierte zwischen 2012 und 2014 noch einmal 880 Mio. Dollar für klinische Studien bis zur Markteinführung Anfang 2014. Inzwischen macht Gilead mit Sofosbuvir 55 Prozent Gewinn pro Jahr. Zum Vergleich: Der Gewinn der größeren US-Pharmakonzerne lag laut der „Forbes“-Liste der größten US-Unternehmen in den Jahren 2005 bis 2015 im Durchschnitt bei 17,44 Prozent, jener der anderen Industrieunternehmen bei 4,34 Prozent im Jahr. Der Wert der Gilead-Aktie hat sich seit dem Aufkauf von Pharmasset in 2011 verfünffacht. Während unter einer sogenannten Zwangslizenz – also einer Lizenzvergabe, die anderen Herstellern die Produktion und Vermarktung gegen eine angemessene Gebühr erlaubt – ein Herstellerpreis von 75 Euro für eine dreimonatige Behandlung inklusive Vertrieb und Gewinn möglich wäre, lag der Preis für eine achtwöchige Behandlung in den USA tatsächlich zwischen 84 000 und 168 000 US-Dollar.[11] Damit hatte Gilead die Übernahmekosten, mit denen es auch die hohen Kosten für die Therapie begründete, in nur einem Jahr weitgehend refinanziert. Der Markteinführungspreis von Sofosbuvir in Deutschland betrug 60 000 Euro, der schließlich verhandelte und von den Krankenkassen erstattete Preis nach einem Jahr bei etwa 45 000 Euro pro Behandlungsphase. In der Bundesrepublik sind von Hepatitis C 400 000 bis 500 000 Menschen betroffen, etwa 300 000 gelten als behandlungsbedürftig. Würden alle mit Sofosbuvir behandelt, entstünden Kosten von 13,5 Mrd. Euro. Das entspricht einem Drittel der gesamten Arzneimittelausgaben der gesetzlichen Krankenkassen im Jahr 2015. Die Aufwendungen der Unternehmen zeigen, dass diese nicht auf die hohen Preise angewiesen sind, um die Entwicklung der Medikamente zu refinanzieren: Gerade die großen Unternehmen geben oft doppelt so viel für Marketing aus wie für Forschung und Entwicklung. Außerdem machen sie 70 Prozent ihres Umsatzes mit Produkten, die von anderen Firmen – oft kleineren Start-ups – entwickelt wurden, also mit solchen, bei denen sie selbst keine Entwicklungskosten hatten.[12] Rund drei Viertel der Umsatzrendite der größten 20 Pharmaunternehmen gehen in die Auszahlung von Dividenden und den Rückkauf von Aktien, um den Aktienwert zu steigern. 16 Prozent werden in Übernahmen und Fusionen investiert und 10 Prozent in Anlagegüter und Sachanlagen.[13] Zudem versuchen die Pharmaunternehmen, durch Übernahmen und Zusammenschlüsse ihre Forschungskosten zu senken oder Steuern zu sparen – etwa indem sie Firmen in Ländern mit niedrigen Steuern wie Irland aufkaufen und ihren Unternehmenssitz formell dorthin verlegen. Ihre Innovation und Forschungsproduktivität erhöht sich dadurch nicht. Schließlich fließt auch viel Geld in die Lobbyarbeit der multinationalen Konzerne – zu „Big Pharma“ zählen Unternehmen wie Jonson & Jonson, Pfizer, Novartis, und Roche. Sie geben in den USA mehr für Lobbying aus als alle anderen Branchen. Pharmageld fließt also hauptsächlich in Marketing und Maßnahmen, mit denen der Monopolstatus verteidigt und ausgedehnt wird – und nicht in die Entwicklung neuer, möglichst wirksamer Medikamente.

tim333 9y ago

Now look forward to its use being blocked for a decade or two by FDA regulations and lawsuits.

avar 9y ago

The latest episode of Econtalk "Vincent Rajkumar on the High Price of Cancer Drugs" is relevant to this subject: http://www.econtalk.org/archives/2018/04/vincent_rajkuma.html http://www.econtalk.org/archives/2018/04/vincent_rajkuma.htm... It discusses structural issues relating to why drugs are so expensive (mainly in the US). Some of it's regulatory (e.g. Medicare not being allowed to negotiate drug prices), or there being no ceiling on prices related to efficacy as in many other countries. But some of it's because nobody in the system seems to have a real incentive to reduce costs, even when the benefits are worth it. E.g. an example that's mentioned is that doctors will usually describe the latest brand medicine that's outrageously expensive, instead of a generic that's cheap and statistically almost exactly the same thing when it comes to efficacy.

deleted 9y ago
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Aloha 9y ago
In every US state that I know of - a generic will be substituted for a brand name drug unless the doctor specifically specifies that it should not be.
- avar 9y ago
  I was unclear, the podcast discusses cases where there's no generic version of the latest drug, and the latest drug is marginally more effective than whatever the latest generic is. So the generic just doesn't get considered, even though it would be suitable for the patient at much lower costs. This is unrelated to the situation you're describing.
  - Aloha 9y ago
    Having a medical condition that requires long term medication maintenance - every single doctor I've had is very well aware of what is a generic and what is not - and tends to prescribe a generic, as they are often an ER version of the regular med, or a compounded version of two medications that can be taken separately.

yread 9y ago

Similar story: 'Coffee filter' helps make new cancer drug Z-endoxifen 1000 times cheaper https://www.sciencedaily.com/releases/2018/04/180405120401.htm https://www.sciencedaily.com/releases/2018/04/180405120401.h...

kyaghmour 9y ago

The price difference is so staggering that it'll just be cheaper to buy a plane ticket to the countries where the cheap one is available and take it there; especially since some countries (Egypt for instance) don't necessarily require a doctor's prescription to allow you to buy some medication from the pharmacy.

bvinc 9y ago
I actually know a good friend that had Hep C that did exactly that. He flew to Egypt and walked into a pharmacy and bought it. I forget how much he paid, but it was closer to $1,000 instead of $84,000.

solidangle 9y ago

These price comparisons are almost always disingenuous. One price only includes the cost to produce the medicine, and the other also includes years of R&D, 10+ years of trials, marketing, and distribution. Sure, the $84000 probably still includes a hefty profit margin, but with all those extra costs the $300 medicine becomes a lot more expensive.

yardie 9y ago
I’m not buying it. Nothing justifies a 300x markup for drugs. State and federal grants cover most of the research. Drug companies only enter the picture near the late stage and only if it’s a viable project.
- chimeracoder 9y ago
  > State and federal grants cover most of the research. That's straight up not true. Most of the money spent on research is obtained directly through pharmaceutical sales in the US, and a large chunk of the rest is obtained indirectly in the same manner.
  - fricat1ve 9y ago
    You keep stating this as if it were a fact, but did it occur to you that delineating what research spending in fact contributed is complex? Medicine is perhaps the industry that most exemplifies one with large confluent streams of money from public, private, and charitable sources involved at different levels of training, research, and practice.
    - chimeracoder 9y ago
      > You keep stating this as if it were a fact, but did it occur to you that delineating what research spending in fact contributed is complex? Yes, as someone who's actually done this sort of tracking and research extensively, it has, in fact, occurred to me that it is a complex task.
9y ago

jlebrech 9y ago

Companies should be able to charge what they want. But also other companies should be able to copy the drugs (shorter patents), especially non-profits. Maybe lab should have to second source production to others and then compete with each other on price.

soVeryTired 9y ago

So did GDP just go up or down?

dfee 9y ago

I worked with a hepatologist once who donated his services to low-income patients with hep c. Encouraged by his selfless act, I called him to learn more about how our services could help him (he was asking for a discount). Well, it turns out that while his services were donated, he also owned a pharmacy and stood to make a lot more by using the donated time as what we might call a “customer acquisition cost”. I would be surprised if he continues treating patients if the payout for treatment really goes down 30 fold. For what it’s worth, that’s a pretty typical physician I’ve worked with and I’ve worked with hundreds. I don’t know why I expect more from physicians, but I do and they usually let me down.

loceng 9y ago
Money as an incentive allows a lot of bad behaviour to exist, and regulating and enforcement bodies don't seem to have proper processes for self-regulation - which would catch this kind of conflict of interest, as one example.
neuro_imager 9y ago
I'm guessing you're in the US where this type of behaviour is typical. Fortunately that is not the case in many other parts of the world where incentives are not as perverse. (physician here)
- chimeracoder 9y ago
  > Fortunately that is not the case in many other parts of the world where incentives are not as perverse. Incentives absolutely are structurally perverse in other parts of the world. They're just perverse in different ways, which often mask the effects to patients.

perseusprime11 9y ago

$300 still sounds good money for most folk to afford. When can we make these free?

zaroth 9y ago
I think what you’re trying to ask is, “Who else can we get to pay for this?” I’m sure you’re not thinking FDA approved drugs will literally rain from the sky and magically fall into your mouth curing you of this horrible deadly disease...
chapium 9y ago
It depends on your country’s politics of course. What level of care do you want to be publicly funded? I have my doubts that the price can remain this low even if the nonprofit controls the IP. If that IP changes ownership or if the nonprofit prices the drug closer to the market value it will likely change. Edit: Also, the price cannot be contained on the fair market unless competitors who can produce the drug are allowed to exist.

chiefalchemist 9y ago

"Harvoni now costs about $48,000 for a 12-week course in Malaysia and $12,000 in Chile. Gilead’s previous Sovaldi treatment cost $1,000 a pill, or $84,000 over 12 weeks. Prices vary around the world and tend to be highest in the US." I can understand slight differences, but this is disturbing. That said, does anyone know the effects on (US) taxes if a drug company lists a cost as $X but has various programs to sell that product at some fraction of $X? Between insurance and such, does anyone really pay full price? So is there some (unknown?) incentive for companies to inflate the list price?

opencl 9y ago
How do you think everyone gets it below list price? The insurance companies are paying the difference. Medicaid pays 85% of list price.
- chiefalchemist 9y ago
  I presume the hospitals and insurance companies negotiate "volume discounts" or similar, effective paying less (but call it whatever you want.) For example, a hospital stay. The insurance company would pay $Y and that's accepted by the hospital - no questions asked. On the other hand, you, without insurance, would pay the "list price" which isn't $Y but $Y+ $Z. This type of price "confusion" only benefits those with the resources and desire to exploit it.

refurb 9y ago

Of course it's cheaper if you ignore all the R&D costs. A good analogy would be software. If I copy a DVD that has AutoCAD on it, I could go out and claim "I'm only charging $5 for my software vs those greedy manufacturers charging $500".

slim 9y ago
So when they recover the cost of R&D they should align with the the cheaper price?
- refurb 9y ago
  Would you make an investment if there was a risk you lost it all, but the best you could expect would be all your money back, not a dime more? Probably not.
- DangerousPie 9y ago
  That's exactly what the limited time period for patent protection is supposed to ensure, isn't it?

shadowtree 9y ago

Great news, the market is working. I don't get the vitriol in the comments, tech plays outs exactly the same. What once cost millions in a data center is now pennies in AWS. Pharco is a normal for-profit pharma company and attacking an established market. Good for them. This hasn't gone through FDA approval yet though, so this is a long time off and a lot of things can happen on the way (nasty side effects killing people, etc). Isn't it great that humanity found a way to cure Hep-C?

Proven 9y ago

Another proof that state “managed” healthcare is unnecessary

exabrial 9y ago

If the new company did the r&d costs then great! That'll force competition into the market and drive prices down. It they stole the IP I'm very sad to see that. Drugs are incredibly expensive to prove they work and they're safe. If we want to continue to receive new cures, we have to let drug companies recoup their costs. The drug patent process definitely needs reform. Eventually these drugs ought to become public domain as everything does so we can advance humanity. I feel a lot better patent system for drugs would be 10-15 years after the drug is approved, with a capped provisional during the process. I feel like the strikes a balance between allowing companies to safely research and protect their cost but also will allow generics to enter the market eventually.

slim 9y ago

When you're ill, you have no choice but buying medication whatever the price asked. $84000 represents more than an entire life of salary in Africa. So essentially giving a monopoly on medication to a company is equivalent to giving them slaves

owlmirror 9y ago
The absurdity of intellectual property. Artificially inducing scarcity with state violence

refurb 9y ago

I'm a little confused. The "new" drug is combination treatment of two hepatitis C tablets, ravidasvir (a new drug) and sofosbuvir. Ravidasvir is novel, but sofosbuvir is the active ingredient in Sovaldi and Gilead has IP protection on it. How do they plan to get around that? The article hints they will work with an Egyptian company to produce it, but Gilead aleady offers Sovaldi for $900 in Egypt. Do they think the Egyptian gov't will turn a blind eye to violating the IP?

philipkglass 9y ago
Do they think the Egyptian gov't will turn a blind eye to violating the IP? I wouldn't be very surprised if they do. Egypt doesn't have powerful domestic IP-reliant industries lobbying for the enforcement of IP. No doubt there are international obligations of some sort, but the benefit of "slash costs for curing a serious disease" is a lot more concrete than the penalty of "the country could face a protracted legal case." It's happened before, with e.g. antiretroviral drugs for HIV in South Africa. Ultimately the pharmaceutical companies backed down, both because they had limited material leverage and because "trying to make poor countries pay more for medicine" is judged in the court of public opinion.
- refurb 9y ago
  But the Egyptian gov't already entered into a deal with Gilead to sell Sovaldi for only $900. I assume that was negotiated in good faith. If that hadn't happened I would agree that the Egyptian gov't could probably care less if someone broke the patent.
  - philipkglass 9y ago
    Saving an additional $600 per patient is significant for a country as poor as Egypt. The existence of an even cheaper alternative strengthens the Egyptian government's negotiating position for agreements going forward. Prices may be re-negotiated further downward in light of this new development. As a rough analogy: consider the effect of sci-hub on recent negotiations between universities subscribing to academic journals and the journals' publishers. Even if the universities do not openly embrace/endorse sci-hub, the existence of an unlicensed near-substitute for the licensed product has strengthened the negotiating position of the universities.

chrisweekly 9y ago

I had to hunt for the article URL from the linked page, so c/p the actual article URL here: https://www.theguardian.com/science/2018/apr/12/non-profits-300-hepatitis-c-cure-as-effective-as-84000-alternative https://www.theguardian.com/science/2018/apr/12/non-profits-...

chris_va 9y ago

People always get really upset with drug pricing, which makes for great headlines but not for rational decision making. In 2030, would we as a society rather have a generic, cheap, openly available HepC cure or not? That is the question you need to ask, and I don't think anyone would say no to that. The $84K drug will fall off patent by then, which means the system we currently have, flawed as it is, will produce that outcome. It doesn't cost $84,000 to manufacture that drug compound. That $300 one even has the expensive drug formulated in it! The $84,000 covers the cost of developing the drug, along with the 56/57 other drugs that generally fail for every one that hits the market, along with a profit incentive to run a pharmacuetical company in the first place. And yes, it's grossly unfair for the patients currently requiring expensive treatment, though solving that through insurance is almost certainly a better idea than regulating prices. If you start regulating drug prices, as have many other countries outside of the US, you disincentivize development. If there is a better way to create cures, that would be wonderful, and I think we would all welcome suggestions. However, there is a reason the US invents the majority of the world's pharmaceuticals. Nothing to date (everything from regulating prices aggressively to prolifigate government spending projects) has worked as well as what we have now for long term results.

systems 9y ago
yes there is, and its called public finance medicine, and health care, in my opinion, seem to fall nicely in that category you as someone who is not infected with the hepatitis C virus, would benefit from others getting cured from it, to reduce the possibility of you catching it and this is just one example and to be clear, i am not saying, that all health care should be exclusively public i am just saying that public finance of not for profit organization working on creating medicine, should be an option
- geezerjay 9y ago
  > yes there is, and its called public finance > > medicine, and health care, in my opinion, seem to fall nicely in that category Then get your government institutions to spend your taxes to do the legwork. Meanwhile, don't hinder progress by barring everyone else from doing the job your state is incapable of doing or doesn't want to do.

bigjimslade 9y ago

Competition drives prices down? Bloated, protectionist government regulations drive prices up? Wow! Stop the presses! This same story in umpteen other contexts has been written time and time and time again, throughout modern history. Get government out of the way. Let people put themselves to work in ways they feel most capable, and watch innovation happen, cost effectively, and to the benefit of mankind! What's old is new again.

greeneggs 9y ago

I would also like to recommend this Nature article, from August 2016, on the same Drugs for Neglected Diseases initiative (DNDi) discussed here. "Busting the billion-dollar myth: how to slash the cost of drug development" https://www.nature.com/news/busting-the-billion-dollar-myth-how-to-slash-the-cost-of-drug-development-1.20469 https://www.nature.com/news/busting-the-billion-dollar-myth-... > In just over a decade, the group has earned approval for six treatments, tackling sleeping sickness, malaria, Chagas’ disease and a form of leishmaniasis called kala-azar. And it has put another 26 drugs into development. It has done this with US$290 million — about one-quarter of what a typical pharmaceutical company would spend to develop just one drug. … In that vein, the DNDi has started research on alternatives to pricey drugs for hepatitis C…

chimeracoder 9y ago
Not to discount the significance of providing new treatments for things like malaria and sleeping sickness, but that's a pretty different category of problem altogether. The model described in that article is aimed at solving a different issue: providing medications for treating illnesses that are largely (though not exclusively) found in the developing world, and for which there is little investment from existing pharmaceutical R&D centers[0]. By contrast, Hepatitis C is the most deadly infectious disease in the US (and is comparably bad in Europe - arguably worse, actually due to inferior treatment options at the moment compared to the US). The cure for Hepatitis C came from a US-based company, out of research conducted on US patients and funded largely by the US pharmaceutical market. You wouldn't see groups like the DNDi tackling that kind of work, because they have vastly fewer resources than larger players do, and they ultimately wouldn't be able to compete, nor would they be able to establish distribution in the markets where they would need to have an impact[1]. Now that chronic Hepatitis C is a curable[2] disease, it's not surprising that other players will focus on providing cheaper alternatives to the treatment course, but again, that's a different problem from what the large pharmaceutical companies in the US and Europe solve. [0] The US is the largest of these, producing half of the world's R&D medical and pharmaceutical research, and Europe is another hub. China and India are the fastest growing, but have only been players on this scale in the last few years. [1] Producing the medication is, in some ways, the "easy" part - actually ensuring that it reaches the patients who need it is the really difficult part, and honestly the more impressive aspect of DNDi's sort of work. [2] Expensive, but curable

RcouF1uZ4gsC 9y ago

That is awesome. If non-profits can research and get a drug approved, they should be able to charge what they want. If for profits can research and get a drug approved, they should be able to charge what they want.

cowsandmilk 9y ago

My immediate question was "how are they getting sofosbuvir for $300?" That is literally Sovaldi and one of the components of Harvoni, which is what the article is comparing this to? Well, they are getting it that cheap because Gilead (the company selling HCV drugs for $84k in the US) licensed it as a generic for sale for this purpose[1]. So, no, this nonprofit didn't discover some cure out of nowhere, they created a combination therapy that uses one of the components of the $84K drug that is available inexpensively due to the owner of the $84k drug licensing that component for generic manufacture in that area of the world. [1] https://in.reuters.com/article/gilead-sciences-india/gilead-licenses-hepatitis-c-drug-to-cipla-ranbaxy-five-others-idINKBN0HA0TI20140915 https://in.reuters.com/article/gilead-sciences-india/gilead-...

mjevans 9y ago
I am curious about the age of that particular component (and skimming the linked article didn't seem like a detailed read would reveal anything of substantive detail). Maybe the modern expensive pre-packaged mixer of drugs is an attempt at re-patenting the actually effective and already existing drug and keeping generics (which could be manually prescribed with the other beneficial ingredients as separate medications) off the market.
- aaavl2821 9y ago
  The components of the drugs are individually not generic and very expensive in the US. Sofusbuvir was discovered in 2007 Sofusbuvir is combined with other drugs (specifically ledipasvir) because it improves cure rates. Because the individual components are still on patent, prescribing each individually would cost more than prescribing the combo
aaavl2821 9y ago
From what I understand, Gilead and many other companies do provide some meds at cost to countries that don't have a system to pay for high priced drugs, especially if they are important drugs for large groups of sick patients Part of this is a corporate social responsibility thing, but part of it is because many of these drugs are purchased and distributed by entities that sometimes cut and dilute expensive drugs and resell them. This hurts patients and tarnishes the brand of the company. Selling their products at cost removes this incentive and allows patients to access the medicines in their unadulterated form So the pharma companies incentives aren't entirely altruistic but it helps patients in the end

lcfcjs 9y ago

Only in America could people get away with charging $84k as a cure FOR ANYTHING.

itissid 9y ago

Here is a thought, for those who have insurance. The insurance company can just give you an all expenses paid 12 business class trips (one per week @~3000$ a pop on the web and much cheaper if purchased in bulk) to go to Malaysia and get the 300$ treatment along with hotel stay for a day or two. And It would still be cheaper by 50%...

Rotdhizon 9y ago

I wonder how long it will be before this non-profit is bought out by a multi-billion dollar pharmaceutical company and that drug price magically skyrockets.

liragg 9y ago

I was about to take Cruise Ship Management in school last year. But unfortunately, when I received the result in hepatitis b test, it was positive. I don't know where I got this. I've never experienced having sex with any man or boyfriend. I was so disappointed at that time. But then again, it is never the end of the world. I repeated the test in a well-known hospital. But, it came back positive again. Early this year i purchase Hepatitis B herbal remedy online from BEST HEALTH HERBAL CENTRE. They told me i will be negative after 4-5 weeks of usage of their Hepatitis B herbal remedy, which i believed and have faith. After 5 weeks of usage, I did another test my HBsAg came negative in routine checkup, so I have done all investigations for hepatitis B. My test reports are HBsAg negative 0.04 on 22/02/2018. I will never stop telling the world about BEST HEALTH HERBAL CENTRE good work in human life ..

liragg 9y ago

HERBAL I was about to take Cruise Ship Management in school last year. But unfortunately, when I received the result in hepatitis b test, it was positive. I don't know where I got this. I've never experienced having sex with any man or boyfriend. I was so disappointed at that time. But then again, it is never the end of the world. I repeated the test in a well-known hospital. But, it came back positive again. Early this year i purchase Hepatitis B herbal remedy online from BEST HEALTH HERBAL CENTRE. They told me i will be negative after 4-5 weeks of usage of their Hepatitis B herbal remedy, which i believed and have faith. After 5 weeks of usage, I did another test my HBsAg came negative in routine checkup, so I have done all investigations for hepatitis B. My test reports are HBsAg negative 0.04 on 22/02/2018. I will never stop telling the world about BEST HEALTH HERBAL CENTRE good work in human life ..