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Friday, March 29, 2024

New $1,000-A-Tablet Drug Can Cure Hepatitis C (Is This Price Even Ethical?)

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A new Hepatitis C medication has hit the market. The name of the drug is called Sovaldi (Sofosbuvir). The cost is $1,000 per pill. Yes, I said $1,000 per pill, and the prescribed regimen is for 12 weeks. This yields an astronomical medical expense of $90,000. However, clinical trials have noted that it cures 9 in 10 Hepatitis C patients. Gilead Sciences is the drug company that manufactures the medication.

The final prognosis of Hepatitis C results in liver transplantation, this usually occurs after severe decompensated Cirrhosis of the liver and treatment failure. The liver can’t be salvaged once this disease progresses to a certain point. Liver transplants cost as much as $577,000 according to an article published by WTOP (a reputable news source for Washington DC). Secondly, Hepatitis C has a 95% recurrence rate after liver transplantation. The public should also note that there are different genotypes of Hepatitis C, some more extensive and severe.

Hepatitis C is transmitted by blood, and sexual intercourse. The Infectious Disease Society of America (the leading medical authority on infectious disease) furnished their epidemiological estimates. The society estimates that approximately 3 to 4 million Americans are infected by Hepatitis C.

There are other conventional therapeutic regimens that include medications like Ribavirin, Interferon, Simprevir, and more. However, many of the traditional regimens come with more undesirable side effects, and don’t produce the cure rate of Sovaldi.

This is critically important, because the Infectious Disease Society of America has actually updated their clinical guidelines for Hepatitis C. The update has made Sovaldi the first line treatment.

According to an article in Forbes Magazine, this same drug only costs $900 to complete the whole regimen in Egypt.

You must ask yourself, “how does the manufacturer calculate their drug price?”. Many times drug manufacturers have to recoup all the expenses in research, drug development, marketing, and etc. However, this is a kind of precedent setting, and especially when you consider how cheap it is in another country but 100 times more expensive domestically.

This is going to throw so many curveballs and monkey wrenches in the Affordable Care Act and Medicare/Medicaid. How will states and insurance companies decide who is worthy of this drug?

The state of Oregon has already initiated discussion on how to limit access to this expensive medication to low income individuals. This is a social joust between ethics and economics. This manifests the true meaning of “the cost of living”. This also accentuates the argument of wealth disparities. A clear and distinct argument can be made about health versus wealth. A 1%’er with Hepatitis C wouldn’t flinch at the cost of this medication, however this budget item could dismantle an entire family that’s struggling in today’s economy. This makes you question the “AFFORDABILITY”, in the Affordable Care Act.

Lastly, this emphasizes the importance of responsibility in lifestyle, and creating wealth base. When individuals participate in risky behaviors such as unprotected sex, and IV drug use, you increase your susceptibility to disabling diseases such as Hepatitis C. The disease itself is physiologically crippling, and so is the burden of expense from pharmaceutical therapy.

We must understand that the interests of pharmaceutical lobbyists reside in maximization of profit for drug manufacturers, and not necessarily the patient in all instances. If the concern for patients were top priority, the government and the manufacturers would devise a more economically affordable strategy to increase accessibility to all infected patients, independent of costs.

What are your thoughts?? Is this a form of medical gentrification? Should the government intervene and regulate drug pricing?

(via The Medical Blog)

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