3 ms·

Available on NHS, though. http://www.ukmi.nhs.uk/applications/ndo/record_view_open.asp?newDrugID=5502 http://www.ukmi.nhs.uk/applications/ndo/record_view_open.

Available on NHS, though. http://www.ukmi.nhs.uk/applications/ndo/record_view_open.asp?newDrugID=5502 http://www.ukmi.nhs.uk/applications/ndo/record_view_open.asp... http://www.pharmatimes.com/article/14-04-16/NHS_England_to_fund_hepatitis_C_drug_Sovaldi.aspx http://www.pharmatimes.com/article/14-04-16/NHS_England_to_f...

refurb 12y ago
I think the reason why Gilead's drug is causing such an uproar is because it is worth the money, yet governments are tired of healthcare costs always going up. A short summary of the issue: In the past HCV had terrible treatments. You would have to take interferon (makes you feel like you have the flu) for 8-12 months. Plenty of patients took their chances on their disease not getting worse. Even if you stuck it out, the cure rate was maybe 50%. The total cost of therapy? Around $80K (for most patients, others were much more expensive). Gilead comes out with a wonder drug Solvaldi (it truly is revolutionary). You still have to take interferon, but only for 12 weeks. If you do tough it out, there is a 90% chance you're cured. The price? A little more than than the $80K of the previous treatments. Honestly, if you think about it, for a little more money, society is get a much greater benefit. So what's the big deal? Well, because this drug works so well and has much better side effects, all those HCV patients who before said "I'll wait and see if HCV gets worse" are now saying "cure me!". There are millions of HCV patients in the US, so if we tried to treat them all right now, it would bankrupt the system. I can tell you exactly what will happen with Sovaldi and the newer drugs being launched later this year: governments and insurance companies will say "no, unless you are very sick, you're not getting this drug". It will still cost the same to cure everyone, but it'll just take longer. Now, if you were Gilead, what would you do? Especially if competitors were coming? I know what I'd do, I'd go to Medicaid and Medicare and say "lets make a deal, I'll give you 50%, 60%, 70% off if you agree to let everyone get treated this year". The gov't would have to pay out a lot in one year, but they'd be getting a deal and Gilead would get their return.
- avalaunch 12y ago
  Just a little correction: you don't have to take interferon with Sovaldi. A lot of doctors are off label prescribing both Sovaldi and Olysio together. Olysio was actually approved to treat HCV a few weeks prior to Sovaldi but wasn't quite as effective in trials. The bulk of the revenue Olysio is generating (which is still quite a lot) is coming from doctors prescribing it alongside Sovaldi. The cost for both together is about $150k but the cure rate goes up a little bit and there are virtually no side effects because the patient no longer has to take interferon.
  - refurb 12y ago
    You are correct! I think Sovaldi's label has with and without interferon, but standard treatment often includes it. Later this fall Gilead and Abbvie will be launching all oral combinations, so interferon will pretty much be gone by end of 2014.
- makomk 12y ago
  From what I can tell, that $84,000 is just the cost of the Sovaldi pills alone.[1] You still have to take it with interferon and ribavirin just like in the traditional treatment - for 12 or 24 weeks rather than the 24 or 48 required without Sovaldi, but that's still going to cost a fairly substantial amount on top of the $84,000 cost of the Sovaldi. [1] See eg http://www.nytimes.com/2013/12/07/business/fda-approves-pill-to-treat-hepatitis-c.html http://www.nytimes.com/2013/12/07/business/fda-approves-pill...

refurb 12y ago

I think the reason why Gilead's drug is causing such an uproar is because it is worth the money, yet governments are tired of healthcare costs always going up. A short summary of the issue: In the past HCV had terrible treatments. You would have to take interferon (makes you feel like you have the flu) for 8-12 months. Plenty of patients took their chances on their disease not getting worse. Even if you stuck it out, the cure rate was maybe 50%. The total cost of therapy? Around $80K (for most patients, others were much more expensive). Gilead comes out with a wonder drug Solvaldi (it truly is revolutionary). You still have to take interferon, but only for 12 weeks. If you do tough it out, there is a 90% chance you're cured. The price? A little more than than the $80K of the previous treatments. Honestly, if you think about it, for a little more money, society is get a much greater benefit. So what's the big deal? Well, because this drug works so well and has much better side effects, all those HCV patients who before said "I'll wait and see if HCV gets worse" are now saying "cure me!". There are millions of HCV patients in the US, so if we tried to treat them all right now, it would bankrupt the system. I can tell you exactly what will happen with Sovaldi and the newer drugs being launched later this year: governments and insurance companies will say "no, unless you are very sick, you're not getting this drug". It will still cost the same to cure everyone, but it'll just take longer. Now, if you were Gilead, what would you do? Especially if competitors were coming? I know what I'd do, I'd go to Medicaid and Medicare and say "lets make a deal, I'll give you 50%, 60%, 70% off if you agree to let everyone get treated this year". The gov't would have to pay out a lot in one year, but they'd be getting a deal and Gilead would get their return.

avalaunch 12y ago
Just a little correction: you don't have to take interferon with Sovaldi. A lot of doctors are off label prescribing both Sovaldi and Olysio together. Olysio was actually approved to treat HCV a few weeks prior to Sovaldi but wasn't quite as effective in trials. The bulk of the revenue Olysio is generating (which is still quite a lot) is coming from doctors prescribing it alongside Sovaldi. The cost for both together is about $150k but the cure rate goes up a little bit and there are virtually no side effects because the patient no longer has to take interferon.
- refurb 12y ago
  You are correct! I think Sovaldi's label has with and without interferon, but standard treatment often includes it. Later this fall Gilead and Abbvie will be launching all oral combinations, so interferon will pretty much be gone by end of 2014.
makomk 12y ago
From what I can tell, that $84,000 is just the cost of the Sovaldi pills alone.[1] You still have to take it with interferon and ribavirin just like in the traditional treatment - for 12 or 24 weeks rather than the 24 or 48 required without Sovaldi, but that's still going to cost a fairly substantial amount on top of the $84,000 cost of the Sovaldi. [1] See eg http://www.nytimes.com/2013/12/07/business/fda-approves-pill-to-treat-hepatitis-c.html http://www.nytimes.com/2013/12/07/business/fda-approves-pill...