this is the pill that cures Hepatitis C. This is that pill on big Pharma

[cali]

[MADem]

1. My goodness, you could have one helluva vacation in India and still come out ahead.

Is there any "Hep C Tourism" happening as a consequence of this disparity?

[cali]

2. yes

http://www.alternet.org/personal-health/84000-hep-c-drug-only-1500

[TheBlackAdder]

6. You've said it.

[IronLionZion]

10. Plenty of Americans have gone to India for surgery too

and other medical treatments

750,000 US residents travel abroad for care each year
http://www.cdc.gov/features/medicaltourism/

https://en.wikipedia.org/wiki/Medical_tourism

[MADem]

40. Not just Americans, either--Canadians and Brits on wait lists.

The premise of "Best Exotic Marigold Hotel" was that the grumpy, surly character played by Maggie Smith would have suffered for months if not years in a wheelchair when she needed a hip operation, so she went to India instead and recuperated (gumpily and in surly fashion--only, of course, the environment changed her, as these ensemble stories do) at said hotel.

[Lancero]

3. Welcome to the modern world, where smuggling medicine is more profitable than...

Smuggling crack or meth.

[TeeYiYi]

47. Not just smuggling...

Also, counterfeiting (selling fake drugs to doctors, hospitals and anyone on the internet) and/or reselling pull-dated medicines to pharmacies.

TYY

[Hekate]

4. Hillary spoke to that recently when she pointed out that a lot of our tax money ....

....goes into the research done by Big Pharma's labs, and that they sell the same medicines abroad for a fraction of what they charge here.

Unless there's any doubt, she's against those practices.

[joshcryer]

5. And really they spend more on ads than R&D.

[TheBlackAdder]

8. Don't forget the sales reps who spring perks and freebies onto the doctors.

[MADem]

41. Ain't that the truth---don't you love those ads?

Expensive production values, cheery themes, beautiful, smiling people, and an announcer listing the side effects at fifty miles an hour....and oh, what side effects!!!!! Gonads may drop off, may cause growth of 2nd head, may cause deafness, incontinence, stop if your feet turn green or you go blind!!!

[SheriffBob]

7. Judas fucking priest

George W Bush is responsible for this.

[hughee99]

67. Exactly. This didn't happen before he was president,

And was fixed once he left office.

[4lbs]

9. Alternet.org had an article about this. $4 per tablet most elsewhere, but $1000 in the US.

http://www.alternet.org/economy/pill-cures-hepatitis-costs-just-4-if-you-live-america-its-1000

12 weeks of treatment, once per day = 84 tablets.


--------------
Prior to the availability of this remarkable drug, hepatitis C treatments involved 6 to 12-month treatments with an interferon-based regimen that provided minimal success rates and was associated with severe side effects including anemia, depression, severe rash, nausea, diarrhea, and fatigue.

In contrast, Solvadi cures almost everyone in a fraction of the time, and mostly without any of the severe side effects.

In the United States, the average cost of treatment for a 12-week course is $84,000 – $94,000. Of course, this number sounds ridiculous, but what should it cost to cure one’s disease?
-------------

[metalbot]

14. I actually can't believe people are upset about this

Let's break this down:

1. Hepatitis C will kill you if you have it and something else doesn't kill you first.
2. Average lifetime cost to treat (but not cure) someone with Hepatitis C is between $500k and $1M.
3. This drug CURES (rather than treats) Hepatitis C at 10-20% of the cost of treatment
4. Pharmaceutical company that spent billions developing this drug, much of which would have been wasted had the drug failed in any one of the clinical trials, then allows it to be sold in third world country at near cost so that millions of people won't die.
5. Outrage!

Ironically, if we didn't have a fucked up health care system, they would be able to make less money in the US, and would have to make up the R&D costs by raising prices in the third world, killing lots of people.

The maker of Solvadi is a publicly traded company. Go pull their financials from one of the financial sites, and then come back and complain about the outrage relative to their profit margins.

I've heard people on this site complain that "drug companies don't invest in medicines that cure diseases, because there's only money in treating diseases". Then when they cure one, at a fraction of the cost of treatment, outrage ensues...

[Vinca]

17. If sick people can't afford the cure, what's the point?

[caraher]

19. Misdirected outrage perhaps?

It's pretty hard not to see this as an outrage, but it's easy to direct the blame toward the wrong target.

Drug development is a risky enterprise that perhaps should be funded as a social good, expected not to turn a profit by later drug sales. Could one not imagine a system under which what people pay for a drug is linked to the cost of its production, while development costs (including all failures) are borne by publicly-supported or subsidized research operations?

I realize there are serious real-world challenges... industry labs might outpace a non-profit research institute in coming up with "winners," the profit motive can be a force for good, too... But it also seems like that last part is taken more as an article of faith, and there's no question that any company driven by profit must not devote resources to cures that will not return a profit. So we wind up with a zillion impotence cures while some deadly diseases are neglected.

[burrowowl]

48. Pharma's get drugs researched by

NIH and then patent them and make HAY!

[Brainstormy]

74. Thank you! Beat me to it. n/t

[True Earthling]

77. NIH grants to for-profit drug co's is less than 2% of drug co. R&D

Not that many drugs are developed by the NIH..and the NIH receives royalties on those drugs that do get to market.

The NIH owns it's own patents for drugs discovered by NIH scientists and can license the tech to for-profits in exchange for royalties. I would expect a lower royalty for drugs discovered by for-profit drug companies funded by NIH grants.

There was a study back in 2000 that looked at approved drugs with over $500M annual sales...Out of 47 FDA approved drugs only 4 were developed in part with technologies from NIH funding.

Total R&D spending by drug co's was over $50B last yr...NIH grants to for-profit drug co's in 2015 was only $863M...less than 2%.

[Ruby the Liberal]

86. Or one could hold out hope that some rich guy

has a grandchild with the same illness as yours has and coughs up the bucks to find relief from it.

[alain2112]

66. Like the way you think

I say that we would all benefit from a public utility style organisation that develops medicines and devices and techniques on a social benefit basis, leaving the private firms to go after their blockbuster billion dollar pills as they please.

Also, I would like to see more appropriate licensing of the results coming out of the publicly funded basis research that drives drug development in the first place. Not just a matter of fees but of exclusivity - a patent, the legal tool that enables these very high price levels, is a government enforced monopoly and we as a nation have the right to insist that this monopoly be used in a socially responsible manner.

Also also, the typical individual in America is not much affected by the list prices on drugs: this is really about the Clash of Titans between the drug companies on one side and the insurance companies on the other with the courts and the various government agencies caught in the middle. I say that this is exactly backwards: any company that is big enough and powerful enough to pressure and dominate an arm of the people's will is too big for the public good and needs to be scaled back. TBTF is most obvious in the financial sector, but the problem is not confined to the financial sector.

[4lbs]

22. The outrage is the massive disparity in cost for treatment in the US versus the world.

~ $400 to $1000 TOTAL for the 12-week course of cure outside of the US,

but at least $84,000 in the US.


But why does the treatment cost 84 to 160 times more in the US than elsewhere?

[metalbot]

33. I could argue that this is actually about saving lives

There's no way that India could afford US prices, except for a very few wealthy people.

Of course, the cynic in me says "well, they are doing this because if they don't, the government of India will turn a blind eye to the creation of generics that will then find their way into the US markets".

The treatment costs more here because we have a fucked up health care system that will pay more.

However, keep in mind that if they weren't making as much money in the US, they'd have to get that profit elsewhere, which would lead to more people in India (and other developing nations) dying.

[Stonepounder]

53. The main problem with your argument is that Big Pharma

can sell the 'rights' to a particular drug to 'Joe Blow Inc.' Who then decides that he can get rich by raising the price of the drug 8000%. He didn't develop the drug. He has no R&D costs to recoup, the company that developed the drug has recouped their costs and decided to sell off the rights. So the only reason 'Joe Blow Inc' raised the price was because they could.

And explain to my just why Congress, in their infinite Republican wisdom, forbids Medicare from negotiating with drug companies to get a better price based on economics of scale.

[True Earthling]

56. Medicare does NOT pay retail for prescription drugs...

There is no direct negotiation but there is a provision for Medicare to obtain drugs at prices lower than retail. Medicare never pays more than the average U.S. wholesale price...the solution is to change the rule to where Medicare never pays more than the worldwide average wholesale price....

Let the Market Control Pharmaceutical Costs

http://www.minyanville.com/businessmarkets/articles/pharmaceutical-pricing-congress-democrats-republicans-pharmaceutical/9/30/2010/id/30328#ixzz4Ht4jEFUG

Congress has directed CMS to never reimburse more than the average wholesale price available in the US marketplace. This policy is a subtle way around the negotiation prohibition because it essentially lets CMS piggyback on price breaks negotiated by private health-care providers, wholesalers, and insurers. CMS can get quite feisty when wielding this limited cost control club, taking drugmakers to court for fraud if they try to hide price breaks given to private parties. This system allows the US government to not pay "over retail," which pretty much everyone can agree is a wise protection of taxpayer dollars.

This system has one certain side effect. US drug consumers get the shaft. The price for any given drug is almost always higher in the US than it is in other developed economies. And it's not just the price. To get their blood cancer drug Velcade approved in the UK, Johnson & Johnson (JNJ) had to agree that it would rebate the government the cost of the drug if Velcade didn't improve the patient's condition.

Everyone raise their hand if they'd like that money-back guarantee on their own health-care expenditures!

Cost controls are more broadly used overseas. That's a fact. The effect of this on American consumers is we bear more than our fair share of drug company profits and R&D expense. When Pfizer (PFE) blew $800 million on its torcetrapib failure, someone had to pay for that. Americans, who pay more for a Lipitor pill than nearly anyone else in the world, paid for more of that R&D failure than anyone.

It should be noted that drug manufacturers go into these negotiations and cut their prices more or less willingly. Sure, some countries threaten to invalidate a patent if a drugmaker doesn't play ball, but to actually do so would ensnare the country in international patent and trade litigation and make them a pariah nation. Drug companies make deals like the makers of Velcade did with the UK because they know they can make up the difference in the US marketplace.

The solution to the unfair burden American consumers bear is pretty simple. In fact, Congress already thought of the mechanism and CMS has the procedures in place to make it workable.

All Congress needs to do is tweak its instructions to CMS. Instead of directing CMS to never reimburse more than the average price in the US marketplace, direct CMS to never reimburse more than the average price in the worldwide marketplace. If a drug company wants to cut a sweetheart deal with another country, that's fine. They just have to cut the same sweetheart deal here in the US.

[Stonepounder]

59. Straw man response. What I said was:

The fact that Medicare is forbidden in the law that created Medicare Part D to negotiate lower prices is no accident. The drug lobby worked hard to ensure Medicare wouldn’t be allowed to cut into the profits which would flow to big Pharma thanks to millions of new customers delivered to them by Part D.

Also note that while the drug companies say they must impose higher prices in the U.S. to pay for research that enables them to innovate and develop new drugs that save our lives. But that’s not true. Half of the scientifically innovative drugs approved in the U.S. from 1998 to 2007 resulted from research at universities and biotech firms, not big drug companies, research shows. And despite their rhetoric, drug companies spend 19 times more on marketing than on research and development.

[True Earthling]

70. What are your sources? "biotech firms" are for profit entities..not sure why it's mixed in

with universities.

Universities who invent new drugs will generally patent the drug then license the drug to a pharma/biotech co. in exchange for some combination of an upfront payment and/or royalty on future sales... or a university scientist will start a company backed by venture capital and obtain the license. I would like to know the percentage of approved drugs that originated in university research.

You stated drug co's spend 19X more on marketing than R&D..that is false. You are probably referring to the Huffpo article on a BMJ report that stated "for every dollar pharmaceutical companies spend on basic research, $19 goes toward promotion and marketing". Basic research is molecule discovery/drug screening and pre-clinical animal testing which is only a small portion of drug development costs.

The most money spent by far is on clinical trials. In general it takes about 10 years from pre-clinical animal testing through approval. Some of the trials can last for years and involve tens of thousands of patients. In 2013 the per-patient cost in a Phase III trial was $48,000.. it's probably closer to $70,000 today.

Most drugs fail before they even enter the clinic and when they do get an IND approval..the failure rate entering Phase I is around 90%? And for the 10% that succeed and go on to Phase II the failure rate is 70%.

R&D spending by pharma/biotech as a percentage of sales is one of the highest if not the highest of any industry. Between 1975 and 2009 R&D spending has more than tripled ..from 5% to 17% of sales. But I agree that they spend way too much on marketing.. they spend more on marketing than R&D..but it's surely not 19X.

Here's an excellent article on the relationship of R&D to marketing spending...

How Much Does the Drug Industry Spend on Marketing?

http://blogs.sciencemag.org/pipeline/archives/2009/07/08/how_much_does_the_drug_industry_spend_on_marketing

There’s now a very useful paper in Nature Reviews Drug Discovery looking at just this issue. The authors (from three universities in the US and Israel) are looking into the general question of which is the better use of money: put it into R&D for the long term, or promote existing products for the short term? I should make clear at the outset that those two options do line up in that way. R&D expenditures take years to pay off, if ever, given the amount of time that drug development takes. And marketing of a current product had better start paying off in a shorter time frame, because every patented drug is a wasting asset, constantly being eaten into by competition and by its time to patent expiration.

Since we’re talking about stock prices, which are generally forward-looking, the way to interpret these results is probably that investors expect R&D expenditures to pay off in the long term, but actually expect sales and marketing expenditures to reduce long-term value. If that’s so, then why spend money on marketing? The reason the authors propose is just what I’d been talking about: short-term reliability. Drug discovery and development is inherently risky, and promotion of existing products is (at least comparatively) more of a sure thing. Companies engage in a mix of the two to try to even the cash flow out. (And as the authors note, if executive compensation is tied more to short-term performance, then there’s an incentive to go with the short-term gains).

[Cicada]

23. Public should share profits because of huge govt subsidies

Most breakthrough drugs spring from govt funded basic research. The govt pays most of the costs to educate the doctors, scientists and technicians who work at RX firms. I think the govt pays one million dollars for the education costs of each doctor.

[metalbot]

34. Source?

I've heard this claim a bunch of times, but I'd like a real source for "most breakthrough drugs come from govt funded basic research". I'd also argue that the "basic research" isn't the expensive part - it's the clinical trials that the government requires. I have several friends who are in the medical research industry, and while you can easily get $100k to $500k grants from the government to do "basic research", it can cost $2B+ to bring a drug to market via clinical trials.

I'd also be interested in the claim that the govt spends $1M for the education of each doctor.

[Cicada]

83. My times Dec 2013 consistent with million dollar subsidy

Charlotte Rampell article Dec 17 2013 "how medicare subsidizes doctor training" says one medicare education subsidy program pays $112642 per resident per year. And that is just one way they subsidize. I read it adds up to about a million per doctor.

As to the share of drug development costs paid by the U.S. govt. Phys. dot org, which is the best source for science news. Used to list funding for research reported. It was astounding how much of the world's best science was funded by the U.S. govt. Certainly MOST of it. Over half. Now fortunately other govts have caught on to the
economic benefits so there are way more breakthroughs from China, Germany, Switzerland, etc but my sense from noticing where funding came from for five years or so for what I consider the most important medical knowledge points to US govt funding. I could be wrong but I would be willing to bet on it if someone like Nate Silver got interested and then told us the answer.

And it is clear to me that big drug breakthroughs come from science, not trial and error or old books of Chinese herbalists.

Think crsprcas9. It will lead to drugs or treatments worth vastly more than every drug ever invented combined. Jennifer Doudna at Berkeley had students and postdocs paid by USA and probably got fed grants as well as her howard hughes funds (and remember that Howard Hughes set up the foundation as a tax dodge so in effect the US Govt paid for it).

[X_Digger]

44. Yeah, no. I have enough doctor (and doctor students) friends to know that's bullshit.

Most doctors leave med school owing $150k-$250k, before even thinking about specialization.

[Cicada]

82. Teaching hospitals get huge payments from Fed govt

I don't know medicine. But I have prepared the tax return for a leading health care provider. The odds the U.S. government pays about a million dollars in direct and indirect support for every doctor trained in the U.S. are good. And having talked to my doctors about the economics of my health care provider after Obama care kicked in has taught me their knowledge of that stuff is minimal. I love em dearly but that's not their thing.

[X_Digger]

85. "I don't know medicine." -- obviously.

Nice goalpost heft though, I'd give it an 8.5 out of 10.

[Cicada]

88. Do you know that just one medicare program pays 10 billion per year to teaching hospitals?

That isn't tuition reimbursement or anything like that. It is an explicit payment to the hospitals to subsidize their educational costs. The Fed's also pay salaries of Residents employed by hospitals in many cases. More billions there. The Fed's also goose up medicare payments for teaching hospitals as further compensation. It really is about a million per student. And I am in favor of that, that's a very good thing to do. My point is that it is fair to allocate some as a benefit to drug firms. Who benefit when they employ doctors. So the drug firms should take some of their excess profit and pay back. It's accounting, not medicine, that we are talking about. Accounting is kinda cool actually, contrary to what folks think.

[Cicada]

89. More detail on govt subsidy med education

2012: medicare 9.7 billion, Fed medicaid 2 billion, state medicaid 4 billion, health resources services administration 464 million, VA 1.4 billion and a new program Teaching Health agency for children's health care, amount not known in 2012. That is 17.5 billion plus explicitly to reimburse teaching hospitals. I think there are 20,000 med students admitted each year, and I think they study for 8 years including residency. 8 times 20000 is 160000 being trained. 17.5 billion dollars divided by 160000 students is 110000 per year for 8 years is 880000 per student. And that's just direct 2012 costs. Add indirect subsidies of many kinds and it's a million bucks per student plus.

[Cicada]

25. Your points are excellent but profit margins are crazy high

And their huge advertising costs probably do more harm than good. Ban RX advertising to public, extend patent term 25%, surcharge their profits 25% to reimburse govt for research and education costs.

[MADem]

42. For that kind of money, why not go to India, rent a suite at a fine hotel for five hundred bucks a

day, and have a nice vacation for half the cost?

[Grudge]

61. Market madness

Your argument really rings hollow.most of R&D for these drugs is done at our universities,along with the NIH.this whole concept of whatever the market will is is exactly why capitalism is so flawed.these pricing disparities are purely greed driven,and we all know it.it's called price gouging.I'm not saying pharma isn't entitled to a profit but jeez!

[FairWinds]

63. Metalbot, you are lying . .

Shame on you for stating that . .

"Pharmaceutical company that spent billions developing this drug, ."

Here is what was really spent . .

"Pharmasset had spent about $62.4 million to develop Sovaldi, including a federal grant of $245,000."

http://www.latimes.com/business/hiltzik/la-fi-mh-gilead-harmed-patients-20151201-column.html

It takes a certain kind of person to go out of their way to defend price gouging from sick people and their insurers.

[NBachers]

71. Gilead, the company marketing Harvoni, didn't develop it. They bought the company that did,

so they could be first on the block to market it. Read the final paragraph in the link provided by Cali: http://www.alternet.org/personal-health/84000-hep-c-drug-only-1500

And then there's Gilead. It didn't even develop Harvoni itself; it made a business decision to pay $11 billion to buy the company that did so it could be first to market and reap the rewards, $26 billion worth. There is something obscene about that. A billion-dollar profit would have been a very respectable return on investment, but Gilead is getting much, much more than that, and all the rest of us are paying for it, one way or another, whether through higher insurance premiums, higher Medicaid costs, or like me, out of their own pockets, just so Gilead's stockholders can see their dividends double. If you buy Hepcinat from India, Gilead still makes a profit as part of its licensing arrangement, but it doesn't make the unholy profits the U.S. government allows it to get away with. And you save thousands of dollars, and you get cured of hepatitis C.

So your "This company invested billions of dollars developing this drug" scenario is invalid. They spent 11 billion to buy the company that developed Harvoni, and then used their inflated pill prices to pay off their investment.

So it's not diligent, science, research based expenses they're profiting off of. It's not science research medicine they're practicing. It's corporate political Pharma Bro Trump-style medicine. And it's indefensible.

Please read this and respond.

[kcr]

84. But the company didn't actually spend billions developing this drug

did you read the article? Did you also miss the part about the same drug being available for far, far less?

Yeah. Imagine being upset about people dying because they can't afford drugs because of price gouging in the US.

[Ruby the Liberal]

87. You might find this interesting.

From NBC today. Where does this fit into your theory?

Mylan Execs Gave Themselves Raises As They Hiked EpiPen Prices

Proxy filings show that from 2007 to 2015, Mylan CEO Heather Bresch's total compensation went from $2,453,456 to $18,931,068, a 671 percent increase. During the same period, the company raised EpiPen prices, with the average wholesale price going from $56.64 to $317.82, a 461 percent increase, according to data provided by Connecture.

And while sales of the life-saving drug rose to provide 40 percent of the company's operating profits in 2014, as Bloomberg reported, salaries for other Mylan executives also went up. In 2015, President Rajiv Malik's base pay increased 11.1 percent to $1 million, and Chief Commercial Officer Anthony Mauro saw his jump 13.6 percent to $625,000.

http://www.nbcnews.com/business/consumer/mylan-execs-gave-themselves-raises-they-hiked-epipen-prices-n636591

[KeepItReal]

11. Drug dose inside an EpiPen = $1...EpiPen itself = $300+

They discovered the drug in 1900, and yet there is only one company selling a solution?!?

[mopinko]

37. any asthma drugs.

an albuterol inhaler should cost a couple bucks, but no....
shouldnt even be prescription.

[MohRokTah]

12. You're leaving out something.

There's a huge lawsuit as two companies claim patent on that pill. The costs of that are huge and are contributing to the high cost to the consumer.

Without that lawsuit, I doubt it would break $100 in India.

[RapSoDee]

13. Whatever you do, DO NOT explore alternative therapies

...or the ever-vigilant Chema-Pharma-GMO TrollHorde will fall upon you with gnashing cursors.

SUPPORT YOUR LOCAL behemoth MULTINATIONAL CHEMICAL-PHARMACEUTICAL-GMO COMPLEX, INC. !!!

[LeftyMom]

16. The natural alternative to pharmaceutical cure of hep c is dying of multiple organ failure

[RapSoDee]

18. Therefore, all you sick folks should sit down, shut up, and pony up $84K

And trust that Big Pharma really does loves you.

[metalbot]

35. Let me ask a question

Before this drug was developed, what would "sick folks" do?

[Blue Idaho]

75. A lucky few of us

Got liver transplants, others were cured by the $60,000 drug treatments, the rest of us died.

[still_one]

60. Isn't that the truth. Pharmaceutical companies go through extensive testing, not only to

demonstrate with double blind studies that the drugs work, but extensive Phase 1, 2, and 3 testing before the drug is release.

The vast majority of "alternative cures", never go through the scrutiny that pharmaceutical drugs go through

[X_Digger]

45. Wait, you realize that the drug in question here is a CURE to hep C, right?

It's not a treatment, in absolute contravention to your cute image.

You get that dissonance, right?

[LeftyMom]

15. A liver transplant is a quarter of a mil, assuming there's a liver handy.

And then you have to take anti-rejection drugs for the rest of your life. Some of those are cheap, some of them are thousands of dollars a month, and you have no way of knowing in advance which ones it's going to take to keep your immune system from rejecting your transplant and killing you.

[Initech]

20. Go fuck yourself big pharma!!!

This should be posted everywhere!

[Hekate]

21. My gods, what a strange, strange thread this has become.

You provide a picture of what is wrong wrong wrong with our medical delivery system, and a bunch of folks with Either/Or; Black/White mindsets tell us to pony up or die; that Pharma pays for all its own research (they don't -- they get a lot of grant money from Uncle Sam, which is OUR tax money, thank you); that Pharma is evil so we should rely on alternative medicine (like my late friend with breast cancer); and I am sure there are more inventive answers out there still to come.

There is no earthly reason this life-saving medicine should cost Americans 1,000 times more than people outside the country. None. It's evil.

[yawnmaster]

24. the bulk of their costs are paid for by the pharma resources. Grant money plays a small part...

directly. There is some indirect support from the govt that is important, but I think you'll find most of the cost of getting a drug through approvals is covered by the pharma company.

[Doremus]

27. R&D for new cures/treatments shouldn't be entrusted to the free market, imo.

We're viewing the results of a 'free market' system for which the well-being of its customers is secondary to those of its shareholders.

Systemic conflict of interest. We need to revamp from the bottom up.

[leftstreet]

28. All R&D costs money. Why is PHARMA entitled to huge profits?

If they can't make a reasonable profit, maybe the gvt should do all research, manufacture and distribution. Perhaps PHARMA should get into the business of making cellphones or something

[Hekate]

31. How is it Americans are expected to pay one THOUSAND times more than non-Americans?

Do tell me how that is justified.

[Sgent]

39. They charge based on the per capitia GDP of the country

Its a sliding scale based on how wealthy the country is.

[True Earthling]

79. Not really..Drug prices are not "charged" by the drug company to each country..prices are negotiated

Countries with state run health systems drive hard bargains..often refusing to supply a life saving drug because it doesn't fit their idea of "value".

At the extreme...India uses the threat of patent invalidation opening the door to generics to negotiate lower prices.

[MADem]

43. +1,000,000!

I have to wonder why anyone would excuse such mendacious usury. It's just WRONG.

[True Earthling]

78. Pharma pays for more than 98% of it's research..the NIH contributes less than 2%

In fact drug company R&D has more than tripled as a percentage of sales and has one of the largest if not the largest R&D spending budgets of any industry.

Not that many drugs are developed by the NIH..and the NIH receives royalties on those drugs that do get to market.

The NIH owns it's own patents for drugs discovered by NIH scientists and can license the tech to for-profits in exchange for royalties. I would expect a lower royalty for drugs discovered by for-profit drug companies funded by NIH grants.

There was a study back in 2000 that looked at approved drugs with over $500M annual sales...Out of 47 FDA approved drugs only 4 were developed in part with technologies from NIH funding.

Total R&D spending by drug co's was over $50B last yr...NIH grants to for-profit drug co's in 2015 was only $863M...less than 2%.

[NurseJackie]

26. This was an interesting article ... (link inside)

http://www.snopes.com/hepatitis-c-drug-prices/

[KitSileya]

49. That was an interesting article.

I would also be interested in seeing how these prices stack up according to median wages. I earn a lot more at my job than a typical American teacher, but prices in Norway are much, much higher for a lot of things, like food. So when I travel to the US or may other places, things look cheap to me. So my standard yard stick is how long would an average citizen have to work to afford this. If I have to work 10 minutes to earn enough money to buy something in Norway, and an American has to work 20 minutes to afford that same something in the US, mine is cheaper, even if it objectively costs three times as much in Norway than in the US.

I imagine that in India, with its rampant poverty, $900 is a lot closer to $84,000 than anyone might think, even if it isn't exactly the same amount.

[NurseJackie]

50. I'd been wondering about that as well.

We're on the same wavelength. You did a much better job of putting things into words that I could have.

[Lisa0825]

73. That is a brilliant way of looking at it!!! nt

[Hoyt]

29. Assuming you are willing to trust your life to counterfeit pills.

[stupidicus]

30. I had it and beat it without the pill

thank dog

[JohnnyRingo]

55. I'd like to know how you did that

I was declared completely cured this month after three months of treatment with Zepatier. The pills were $800 each and required three months of daily treatment. I had to fight the insurance company for the previous nine months while the Hep C destroyed my liver like a dripping faucet of death.

Needless to say, when I discovered I was afflicted I did a lot of research and found no serious options beyond Harvoni and Zepatier. Since the symptoms are subtle, how do you know you're cured?

[stupidicus]

58. immune system

some 15-20% are able to kick it without the drugs.

I was diagnosed in 2002 by a plasma company and then my local Board of Health (although I haven't been able for the life of me been able to figure out where I got it) and recently declared free of it -- meaning it's no longer detectable in my sustem.

[JohnnyRingo]

68. I don't know where I got it either.

I'm not an IV user nor do I participate in unsafe sex, though that's an unlikely way to contract it.

The most common way these days is through tattoos. Unless a shop uses new needles and ink bottle every time a single cell will infect the blood. With tattoos being so popular among young people there will probably be an epidemic in ten years, a normal gestation period for HepC. Snorting cocaine with infected individuals is another way to get it and could be how Baby Boomers are seeing a recent surge in cases.

I don't have tats, and haven't done coke since the early '90s. I suspect I got it during a stay in the hospital. Doctors don't want to consider that possibility and focused on the cure and preventing further infection to innocents.

I hope you make sure there's no recurrence since you seemed to beat it in such a unconventional manner. All it takes are a few cells to replicate and cause a relapse that you won't know about until it's too late and you're on a liver transplant list. I would be skeptically cautious that it just went away. Indeed, I have a scheduled appt next week for a follow up test.

[stupidicus]

69. well

it's not just that it's no longer detectable in my case, but the fact that there hasn't been any discernable damage done to my liver by it. So even if it should somehow manage to barge back in it would pretty much put me on the starting line in terms of long term damage. Given my age and the time it needs to put someone in your condition, I'll likely die of something else first.

My recollection from researching it is that it usually takes 15-20 years before it becomes a life theatener. Furthermore, while I am not sure I'd think that they use the same standard for having been declared "cured" -- no longer detectable -- whether it's done with the drugs or by ones own immune system. So going forward we're in much the same boat outside of the organ damage you've suffered.

[bluedye33139]

32. Does Gilead have a program to distribute the drug for free?

I have helped clients access HIV meds through Gilead before, and for clients who do not have insurance or are not covered by an ADAP or AIDS drug assistance program, Gilead will massively reduce or entirely do away with cost for HIV medications. I wonder if they have such a program for hep C?

Near the end of the primary season, the Sanders campaign was going to battle with HIV activists over their participation with Gilead in the free drug program. Peter Staley in particular was singled out, in a very ugly way. But as HIV activist have proven, the pharmaceutical companies can be reasoned with. Concerned parties might want to organize and learn some lessons from the incredible successes of HIV activism in the United States.

[Blue Idaho]

76. Yes, I was on the program

I don't know what the program is like now but about two years ago all it took was being denied twice by your insurance company. That and a combined family income under $75,000 if I remember right.

I paid zero dollars for my Harvoni treatment and have just passed my one tear post treatment viral test.

[bluedye33139]

80. I mistrust big Pharma but when they come through like this

it makes me a little more tolerant.

And I hope that you enjoy continuing health for many decades to come!

[bobja]

36. My GF Took Solvaldi for 6 months

One pill a day at about $1000 each. That's over $180,000, but paid for by Medicare, thankfully. But it worked! She's totally free of Hep C!

[bluedye33139]

81. Hep C cure is one of the happiest successes in medical research

The cost is insane, but whenever I hear of people being cured of hep C, I am happy.

[Wilms]

38. ^/r

[Avalux]

46. Hepatitis C treatment with Soldavi includes either ribavirin and/or peg interferon.

It's not just the pill that cures Hep C; it's the combo with drugs already used to treat it. It's also NOT a novel new drug; it's been re-formulated from something already discovered.

Just some facts to keep in mind. Now on to drug-pricing politics....

Because Soldavi isn't really a new drug, India and other countries refused to grant a patent to Gilead. Instead, Gilead has contracted with generic drug companies in those countries to manufacture Soldavi and sell it for less. If Gilead doesn't agree to this, then the drug could be manufactured without them in those countries and they get no profit whatsoever.

[cali]

51. Thanks for the information, Avalux

[True Earthling]

52. India is notorious for using patent invalidation to threaten drug co's to lower prices

India's lack of conforming to global international patent standards is one of the reasons there has been a lack of foreign investment in India.

Solvaldi is mainly for GT3 patients..the majority (75%) of HCV pts in the U.S. are GT1 and are prescribed Harvoni which is Ledipasvir/sofosbuvir.

Sofosbuvir/Sovaldi was developed by Pharmasett and is not a re-formulated drug...

Inside India: India’s Fight Against Big Pharma Patents Is a Just War

http://blogs.wsj.com/indiarealtime/2015/03/19/inside-india-indias-fight-against-big-pharma-patents-is-a-just-war/

In January, India’s patent office rejected a patent application from the U.S. biotech firm Gilead Sciences Inc. for a hepatitis C treatment, saying that the hepatitis C drug was novel but similar to a known compound. It also said the drug didn’t show a significant improvement in efficacy over previously known compounds.

[samplegirl]

54. I know a fellow D.U.er who needed this drug

Someone I have been close to for years and had no idea how he got it. They would not approve him for any type of drug.
Finally a generic form was finally offered to him because he had a wonderful persistant Nurse practitioner who really did care about his health status.
Thankfully he finished his course of the medicine and is now Hep free from his blood results.
I don't know why they claim to have the cure in all the commercial ads when most people can't even obtain the drug.

[paulkienitz]

57. a friend of mine is on that pill right now

despite having no money. I'm not sure how much the taxpayers are getting stuck for by the company, but I don't think it's anywhere near list price.

[still_one]

62. no it isn't the list price There are mechanisms to provide it for people who cannot

afford it. I know a physician who utilizes harvoni quite frequently in the prison population, and yes, the taxpayers do foot the bill as is the right thing to do both morally and ethically

[FairWinds]

65. There are some amazing lies being told on this thread . .

According to the LA Times, it cost only $ 62 million to
develop Solvaldi.

People here are actually trying to rationalize and justify
the gouging of sick people and their insurers.

Just amazing.

[cstanleytech]

72. I wonder if the varies pharmaceutical companies will still be able to get away with that

price gouging with the TPP if it passes of course.

[Initech]

90. Big Pharma sucks.