"A new pill to treat hepatitis C raises difficult questions about fair pricing, not only in the United States and other affluent nations but in developing countries around the world. Hepatitis C, which afflicts some 150 million people globally, often without symptoms for years, can cause fatigue and fever, cirrhosis or liver cancer."
The pill, known as Sovaldi, or generically as sofosbuvir, costs $84,000 for a standard 12-week course of treatment. That breaks down to $1,000 for each pill, taken daily. The manufacturer, California-based Gilead Sciences, says private insurers are already covering Sovaldi...Now, where have I heard about a panel in relationship to healthcare? The name Sarah Palin pops into my head. That woman, Sarah Palin, didn't know what she was talking about, they all said.
Gilead says the price is consistent with the cost of previous treatment regimens (a contention disputed by independent experts) and is reasonable given that the drug can have fewer side effects and cures a higher percentage of patients compared with other drugs...
However, a panel of experts at a recent forum in San Francisco concluded that the drug offered “low value” for treating most patients, in large part because of its high price. READ MORE
25 comments:
NYT: "How Much Should Hepatitis C Treatment Cost?"
However much the person who persons providing the treatment wish to charge.
There, that was easy.
Who was our Hep-C guy? I seem to remember someone either here or on TOP discussing his positive results with a new treatment, presumably this one?
Bagoh. Don't remember if he mentioned what his specific treatment plan was.
Mitch ... That is bagoh20.
And the "panels" have already begun within the hospital settings. My cancer screening follow ups and screenings now must past muster with a 3rd party committee where once the hospital's tumor board made the decisions on alternatives. Fortunately both the Tumor board and the 3rd part agreed on my follow up regimen. For now anyway.
A 3rd party has been added. Only good thing is that the 3rd party can mandate more comprehensive testing & treatment if they think it is worth while. They did so in my case.
None the less, another group is now in the mix. I hope it remains positive where I am a patient.
Rev, I don't know the interconnections, if any, between publicly funded universities that contribute toward private research or what tax loopholes and corporate welfare may exist for drug companies, but wouldn't it be fair to factor in these kinds of thing when formulating the price?
The article asks this question...
What can or should be done to reduce the cost in the United States?
...and then then fails to provide the most obvious answer: institute rigorous reforms to tort law.
The cost of risk is baked into the per-pill price quoted for patient treatment. It's high in the US, abut lower in other countries because of their system of tort laws. Same pills, different countries.
You can't watch an evening of television or two hours of radio without seeing or hearing commercials from big tort law firms soliciting clients who have used this pharmaceutical or that treatment. Pharma companies are ripe targets for suits because their products are sold to sick people who often experience side effects.
Solve the tort law problem and the cost of treatment will come down.
Fail to solve the tort problem and we'll all face government death panels at some point.
Yea, I'm taking it. I'm in week 10 and the virus disappeared from my blood after 14 days and has not returned. Woohoo!
I've had this virus for 36 years, and have been fighting it and the cancers it produces for 12 years now. I've had my liver replaced, lost my gall bladder, 1 rib, and part of my diaphragm. I spent a year sick on interferon injections that in the end failed to cure me, having only a 50% cure rate. This new drug has a 92% cure rate on the toughest form of the virus which I have. The panel of experts in San Francisco said it provides "low value". My panel of experts says fuck you. My private non-ACA, and very reasonable insurance plan approved the drug for 24 weeks if I want to take it that long. It has absolutely no side effects, and I feel great. I loves me some medical science and private health insurance.
I want it.
Of course it costs too much, but if it didn't, it wouldn't exist and people would die. Saving lives is not usually easy or cheap. The price will come down, but the alternative to high initial cost is to simply not discover many cures.
Looking at the chemical structure of sovaldi, there's nothing there that makes the drug intrinsically worth that price tag. If you can locate the fluorine atom in the structure, you'll realize that that's where the action is--otherwise the the molecule resembles a natural product.
The costs reflect the return on investment and the price of doing successful research, including all the failures. If there were a cheaper way to price development costs out of the picture, new drugs wouldn't be so costly. If everybody, including patent attorneys, would just agree to work for free, the pricing would improve.
Once the drug comes off patent (20 years from the priority date of filing), the price will plummet.
I'm glad the drug was there for you in time, bagoh20.
wouldn't it be fair to factor in these kinds of thing when formulating the price?
Not unless the tax credits and/or research came with an up-front disclaimer to that effect.
Imagine that you personally discover a cure for pancreatic cancer tomorrow. Would you accept the government saying "you took the mortgage interest deduction last year, so we get to say how much you can sell your patent for"? Of course not, because there was no string attached to the deduction at the time you took it.
Ex post facto law is a bad thing.
I'm digging the proper chemical name for sovaldi because it conforms to my German language analogy for chemical names: the name has a separable prefix verb style structure wherein the first word and the last word go together like parentheses enclosing the goop in between: Isopropyl (2S)-2-[[[(2R,3R,4R,5R)-5-(2,4-dioxopyrimidin-1-yl)-4-fluoro-3-hydroxy-4-methyl-tetrahydrofuran-2-yl]methoxy-phenoxy-phosphoryl]amino]propanoate
@bagoh20: would you like to see a blog post on the structure/function of sovaldi?
bagoh said:
"Of course it costs too much, but if it didn't, it wouldn't exist and people would die. Saving lives is not usually easy or cheap. The price will come down, but the alternative to high initial cost is to simply not discover many cures."
Normally I would agree with you. But in this particular case Gilead's purchase of the developing company, Pharmasset, and the subsequent pricing decision looks to me like it passes beyond recovering development costs plus a good reward for taking a risk and into unfettered greed.
And while Gilead has a right to be greedy, I have a right to consider them amoral scumbags.
If someone can find a cost analysis which justifies the price, I would be glad to read it. From what I've seen, Gilead hasn't offered any financial basis for their decision.
There does seem to be a great deal of professional propaganda coming from both sides of the issue. A lot of that is coming with mainstream media bylines.
@Rabel: There's a huge disconnect in pricing drugs. For example, the people who most need HIV drugs and the fruits of future HIV research couldn't afford to pay the bus fare for a Boston Metro lab tech going to work on any given day.
Like I said, if everyone would agree to work for free, the costs would come down.
There are examples of drug companies moving discovery phase R&D to universities and institutes to benefit from cheap grad student labor.
But in this particular case Gilead's purchase of the developing company, Pharmasset, and the subsequent pricing decision looks to me like it passes beyond recovering development costs plus a good reward for taking a risk and into unfettered greed.
This is the standard model now. New drugs are discovered at small start-ups, usually driven by lone geniuses funded by high-risk investors. Big Pharma watches for promising leads. There is much less in-house development of new drugs.
Chick,
Like I said, normally I would agree. This one has a stink about it.
But in this particular case Gilead's purchase of the developing company, Pharmasset, and the subsequent pricing decision looks to me like it passes beyond recovering development costs plus a good reward for taking a risk and into unfettered greed.
A quick Googling indicates that Gilead paid $11 billion for Pharmasset, pretty much exclusively to gain access to the drug.
So that's 11 million pills sold just to break even (assuming the pills are made and marketed for free).
And one tell would be - what were Pharmassets plans on pricing.
"pretty much exclusively to gain access to the drug"
Yes, but they got much more with the purchase of Pharmassett than just the Sovaldi patents. Your numbers need work.
And even if you work from the full 11 billion number, that's 131,000 patients. There are several million hepc sufferers in the US alone.
Right on, Bagoh.
but wait... You don't want to call
1-800-luv-your-GOV and ask permission first?
Then pay a higher government/-insurance company graft price that was culled thru the tax payer?
Where very expensive drugs shine is with rare diseases that would never be worth the research otherwise. If there were only say 100,000 Hep C patients, would the price be fair? Also remember that new cases of Hep C have been in decline and with this drug the company will eventually eliminate it's own market.
Snake oil, or global warming - now that's smart business.
Yes, but they got much more with the purchase of Pharmassett than just the Sovaldi patents.
Feel free to provide an argument as to the value of the "much more" that they got.
Your numbers need work.
Yes, I know. I assumed the pills were made and distributed for free, which obviously isn't true.
And even if you work from the full 11 billion number, that's 131,000 patients.
Assuming the pills are made and marketed for free and that the 11 billion dollars would have otherwise been sitting in a bank earning 0% interest, yes.
There are several million hepc sufferers in the US alone.
And?
The likely strategy being pursued here is the same one usually pursued with new technologies: you hit the early adopters for higher prices to quickly recoup your up-front costs, then you lower the price for the mass market and try to find the sweet spot where purchasers times net profit per unit yields the largest total.
Remember, according to the left, corporations are not people, therefore they can't be greedy. Maybe they are just responding to incentives.
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