10 ms·
Antiviral drugs for hepatitis C are very effective, but they come at a steep cost. Just one Sovaldi pill costs $1,000. A full 12-week course of treatment with t
by yakz 7y ago
Antiviral drugs for hepatitis C are very effective, but they come at a steep cost. Just one Sovaldi pill costs $1,000. A full 12-week course of treatment with this drug costs $84,000.
The price of other hepatitis C drugs is also high:
Harvoni costs $94,500 for a 12-week treatment
Mavyret costs $39,600 for a 12-week treatment
Zepatier costs $54,600 for a 12-week treatment
Technivie costs $76,653 for a 12-week treatment
https://www.healthline.com/health/hepatitis-c/treatment-costs#2 https://www.healthline.com/health/hepatitis-c/treatment-cost...
- idclip 7y agoJesus how much did these drugs cost to develop? Are these numbers justified?
- ohyes 7y agoIt’s priced based on ability to pay. US it will be 100,000 other countries it will be less.
- Cougher 7y agoIt isn't priced on the customer's ability to pay: it's priced on the companies' ability to gouge.
- ohyes 7y agoWell, it is discriminatory pricing. If someone isn’t saying it is too expensive you haven’t priced the product aggressively enough. In the US market the profit was maximized at 100k, in other markets the profit is maximized at a lower price level because almost no one can afford 100k.
- r_singh 7y agoYup, the generic version of the drug is price at $384 per bottle of 28 pills in India Here's an article on how the patent did not affect it's price in India: https://m.economictimes.com/industry/healthcare/biotech/pharmaceuticals/patent-not-to-affect-hepatitis-c-drug-price-in-india-gilead-sciences-inc/articleshow/52228499.cms https://m.economictimes.com/industry/healthcare/biotech/phar...
- lawn 7y agoAbility to pay? Is that a joke? Considering that 40% of Americans can't cover a $400 emergency expense[0], what makes you think they can pay $84,000 for a 12-week treatment? [0]: https://money.cnn.com/2018/05/22/pf/emergency-expenses-household-finances/index.html https://money.cnn.com/2018/05/22/pf/emergency-expenses-house...
- jacquesm 7y agoMaximized for the total bottom line it isn't a joke. That some people die is not a consideration for those that control access to these drugs, the question is how many people should die in order for them to make the most money of the ones that stay alive. Think of the ones that die as marketing.
- claudeganon 7y agoThis is the only sincere appraisal of the healthcare industry in the US I’ve seen on HN in months. Thank you for your clarity.
- lol2143651 7y agoThe way it generally works for these drugs is the insured get it covered and the uninsured get it cheap or free.
- nkozyra 7y agoAs with most commercial goods there's a market identified and the goods priced accordingly to maximize profit. This means that somebody is priced out no matter what. Given the state of American healthcare it's easier to reconcile if you remove the emotional part and view a drug treatment as, say, a television. If I make a 50" television and price it at $500, I accept that some people will not buy it and target my television to my intended market. What I'm saying is the drug companies are probably fine saying "ok, some people can't afford it, but we maximize profit by selling at a premium to those that can." All that said, if it's life saving you might be surprised what people can and will do, savings notwithstanding.
- 7y ago
- chmod775 7y agoIn many other countries getting treated for hepatitis C won't cost you a dime besides your regular health insurance payment. Prices are often negotiated by health insurers and are pretty much guaranteed to be lower for that reason. Depending on what system you are in, you might never even learn what your treatment cost. Not that you should care.
- twoodfin 7y agoThat depends on the treatment and politicians’ willingness to pay for it. Take cystic fibrosis in England: Until this year, modern, highly effective (and, yes, expensive) treatments available for years in the US—covered at low out-of-pocket cost by insurers there—were unavailable through the NHS.
- 3fe9a03ccd14ca5 7y agoThe exception or the rule?
- makomk 7y agoThe same was true of hepatitis C in England - even though NICE, the body responsible for assessing what drugs should be available on the NHS, found that the new treatments were cost effective at the price they were being sold for, the NHS balked due to the total cost of curing everyone and refused to offer it to anyone except a handful of patients who already had severe liver damage.
- refurb 7y agoThis is true. The new HCV drugs, even at the outrage inducing price of $90k, easily met the NICE cost effectiveness threshold. The issue was really volume. There wasn’t enough money to treat everyone.
- ameister14 7y agoDrug R&D includes failures - not saying they aren't for profit companies but there is significant cost (in the billions yearly) and risk in running a pharmaceutical research company
- spaginal 7y agoThese drugs are priced this high for the sake of health insurance and the screwy pricing market based around it. When you get the final bill with the “adjustments” and “discounts” it will be far less. If you signaled to the provider you are paying cash it’s far less. My physical therapy was $1200 a visit to my insurance provider, and magically $40 out of pocket once my insurance cut off my covered trips.
- Tharkun 7y agoDrug development is incredibly costly. It's also something of a long term gamble. It can take 10-20 years to develop a new drug. A lot of that time is spent testing safety and waiting for approval. As a drug company, you need to have several new drugs in your pipeline at any given point, or you'll be seriously fucked if one (or more) of your products don't pan out. It's basically a high-risk-high-reward type of gambling situation. Imagine having thousands of people on payroll, some working on drug design, some designing experiments to test the drugs, some doing the legal paperwork to get drugs approved etc, and suddenly the patent for your best selling drug expires and your latest drug doesn't work. You're pretty much boned.
- dfsegoat 7y agoThe development costs per a Forbes analysis are as follows: > "The median per-drug R&D spending of companies that developed more than six drugs – that’s only 8 companies – was $5.8 billion." ...so that is $5-6B USD per drug DEVELOPED in large companies. Gilead - maker of Sovaldi/Harvoni for HepC treatment - has been on a development tear of late, and almost certainly falls into that range IMO [2]. For companies that produce fewer drugs - the estimates are between $700M-$1B per drug. Note these are prices for drug R&D only ("development") - there is no guarantee those drugs developed make it to market ("approval") - Over 90% do not. edit: source links 1 - https://www.forbes.com/sites/matthewherper/2017/10/16/the-cost-of-developing-drugs-is-insane-a-paper-that-argued-otherwise-was-insanely-bad https://www.forbes.com/sites/matthewherper/2017/10/16/the-co... 2 - https://en.wikipedia.org/wiki/Gilead_Sciences#2010_to_2019 https://en.wikipedia.org/wiki/Gilead_Sciences#2010_to_2019
- yoloClin 7y agoI imagine those numbers wouldn't be all that reliable for a bunch of reasons - companies would have vested interests in over or under reporting costs for various reasons, technology progressions mean previously expensive to develop drugs may be cheaper if they were to be redeveloped now, and sample size probably wouldn't be large enough for the raw data to be used when bankrolling pharma research ventures. Edit: I should contextualise this by noting I have basically no experience with pharma so grain of salt blah blah
- idclip 7y agoI dont think you should be downvoted because thats valid, yet hard to use as an argument, paranoia. The basic assummption in cryptography is “assume the target system is already compromised” so i would wager you are partially correct. Its just that its not the whole story, especially if u think that private persons get massssive discounts if they try to privately pay (from reading below comments about quotes to insurance companies vs private people). Its a sad dynamic thats probably ruining more loves than it should.
- dfsegoat 7y agoI think your points are fair. Sample size for their analysis was about 100 drugs. FDA approves about 25 per year. My main point is that drug development is more expensive than most realize. Beyond R&D, a lot of that cost is in postmarketing (after approval) safety studies and surveillance- to catch side effects not observed in clinical trials. This process can be made somewhat more efficient as you suggested, but at the end of the day a human is reviewing every side effect report and reporting those back to regulatory agencies etc. I am not qualified to discuss the economics re: your point on pharma r&d - drug discovery is it’s own thing aside from actual drug development.
- deleted 7y ago[deleted]
- inasio 7y agoIt cost exactly 11 billion for Gilead to "develop" Sofosbuvir (they bought Pharmasset who discovered the drug [1]) [1] https://en.wikipedia.org/wiki/Sofosbuvir#History https://en.wikipedia.org/wiki/Sofosbuvir#History
- refurb 7y agoThey didn’t buy an approved drug, they bought a clinical lead. They still spent a ton getting it approved.
- save_ferris 7y agoThat is so depressing to read. US pharma companies are completely out of control, there’s absolutely no reason a 12 week treatment should cost around the mean annual US income. Can’t imagine having to decide to risk my entire financial future to deal with Hep C.
- mc32 7y agoI would hope that as more people test and get treated and the drug production gets ramped up, the price should go down significantly. A couple of decades ago only people like Magic Johnson could afford HIV drugs, for example.
- whatshisface 7y ago>there’s absolutely no reason a 12 week treatment should cost around the mean annual US income. What if it was synthesized in 5,000 steps from pure gold or something?
- gcatalfamo 7y agoBut is it though?
- whatshisface 7y agoI can't find any references that say the cost of manufacturing it or inventing it, so the only indication we have that it is expensive is the high price. Interferon is an entire protien so it can't be that cheap.
- Bnshsysjab 7y agoI’m not trying to disregard the need for cheap treatment, but by preventing pharma from developing drugs that they profit from kills all R&D. I’d be open on a success based public funding where IP becomes public domain, but I doubt big pharma would ever pull that trigger. I’m thankful for modern day drugs, like PReP and PEP (pre and post hiv exposure drugs), vaccines and cancer treatments to name a few, it just sucks that those less fortunate don’t have access yet.
- dd36 7y agoThere’s a $300 treatment on the way: https://www.dndi.org/2018/media-centre/press-releases/new-affordable-hepatitis-c-combination-treatment-shows-97-cure-rate/ https://www.dndi.org/2018/media-centre/press-releases/new-af...
- coder1001 7y agoor go to India now and be treated for $1k [1]? [1] https://www.medicaltourismmag.com/article/hepatitis-c-treatment-india https://www.medicaltourismmag.com/article/hepatitis-c-treatm...
- 3fe9a03ccd14ca5 7y agoIt’s basically to the point where it’s: > Go to <any country outside the US> and be treated for <fractional amounts>
- wtdo 7y agoAs an American, how does that work in practice? I know I can go to Vietnam and be treated for a small amount (I was in a Vietnamese hospital for a couple of days due to a really bad strep infection and dehydration as I was unable/unwilling to swallow, and in a separate incident, also had a round of rabies shots after being bitten by a dog there). I figured it was cheap because everything is cheap there and no one there could afford it otherwise, not because of government insurance. But if I go to Australia, Canada, UK, or any other country, how do I get access to this cheap healthcare without becoming a citizen or paying taxes? Do I qualify just by nature of being there with a valid visa?
- tonfa 7y ago> But if I go to Australia, Canada, UK, or any other country, how do I get access to this cheap healthcare without becoming a citizen or paying taxes? You'd likely pay more than a resident/citizen who may not pay or may a token amount. But this full price will still be very small in comparison to US (eg full price of doctor's consultation in France is like 25 EUR). Even Switzerland which is expensive for Europe in terms of healthcare is cheap comparatively (a simple ER visit might be a few hundreds, not thousands).
- Allower 7y agoId rather die than give them the satisfaction of successfully charging me that ridiculous amount.
- trimbo 7y agoThey're priced this way because they're 80-90% cheaper than the previous treatment. Previously, with no cure, HepC patients would have eventually had a liver transplant. Liver transplants cost between $500K-$1M. Of course, it also requires a liver, so many would die waiting for a liver. As you noted, the drugs have become much cheaper. Mavyret is ~1/2 the cost of Sovaldi, the first drug on the market (replaced by Harvoni). Mavyret actually only has an 8 week treatment, which is an improvement over the 12 weeks of Harvoni. The competition within these drugs became so fierce that, despite these prices, no new ones are planned (last I read). In fact, one you listed here has been off the market for over a year https://www.empr.com/home/news/two-hepatitis-c-virus-infection-treatments-to-be-discontinued/ https://www.empr.com/home/news/two-hepatitis-c-virus-infecti...
- deith 7y agoPro-tip: it doesn't actually cost $500K-1M to transplant a liver (which you get for free).
- pc86 7y agoDo you have a source for this?
- dajohnson89 7y agoI think he means we're all born with a liver. And transplanting your liver is a matter of walking.
- 0xB31B1B 7y agoIt costs an insane amount of money. 1) there is a large infrastructure around organ donations that needs to be maintained 2) it generally requires the organ (and some times doctor) to be flown on a private jet from where the organ comes from to the person receiving the transplant 3) transplant surgery is a very long procedure requiring multiple specialists 4) recipient is on a lifelong course of drugs (literally like a handful of expensive drugs every day) that suppresses their immune system so the body doesn’t reject the organ Source: wife is a doctor at research hospital
- stevespang 7y agoCould it be that those recommending everyone get screened have a financial interest, or investments in those companies that produce the medicines . . . stranger things have happened . . .
- bra4you 7y ago"Harvoni costs $94,500 for a 12-week treatment Mavyret costs $39,600 for a 12-week treatment Zepatier costs $54,600 for a 12-week treatment Technivie costs $76,653 for a 12-week treatment" I assume that your healthcare covers this. Otherwise cheap imports are available from India, e.g. https://roidgear.net/hepatitis-c https://roidgear.net/hepatitis-c
- deleted 7y ago[deleted]
- refurb 7y agoThese are the list prices. Due to competition, net prices came down considerably as the different company try and get market share. Current prices are closer to $30,000 or less per dosing regimen.
- jokowueu 7y agoIf you go to Egypt it's much cheaper http://www.tourncure.com/en/ http://www.tourncure.com/en/
- gengchun88 7y agoIf you are talking about a virus only affect small amount of population, I can understand this marketing strategy. But Hepatitis C. is a virus infects 143 million, which means it even with a $10k profit margin for one in ten here should be at least $1 Trillion profits. A company like BMS do expanding like $20 billion annually. For me all most like they could afford to operate like half of century for just one drug. No way it is sold for almost $100k price for just breaking even. Correct: Sorry it was Gilead Science developed Harvoni. So $22B revenue minus $8 operating incoming.
- inasio 7y agoNo, Gilead didn't develop Harvoni/Sovaldi/Sofosbuvir, it was originally discovered by Pharmasset, and then Gilead bought them for 11 billion [1] [1] https://en.wikipedia.org/wiki/Sofosbuvir#History https://en.wikipedia.org/wiki/Sofosbuvir#History
- gengchun88 7y agoOh, thanks. That simplified R&D cost calculation. $11B for $3.5 m persons in U.S. and 90% successful rate means R&D cost(merge cost) definitely less than $4k per person.
- Jnr 7y agoIn some EU countries treatment for hepatitis C is already included in the government sponsored healthcare program.
- chimeracoder 7y ago> Antiviral drugs for hepatitis C are very effective, but they come at a steep cost. Just one Sovaldi pill costs $1,000. A full 12-week course of treatment with this drug costs $84,000. It's worth noting that, in the US, almost nobody is actually paying those prices. Most insurance plans these days cover HCV treatment, and even insurance companies aren't paying those sticker prices to the pharmaceutical companies when they cover these drugs.
- mister_hn 7y agoCan't they be covered by Health Insurance companies?