For sufferers of hepatitis C, there’s some good news and some bad news. The good news: a new drug launched this year has proven itself the most effective hepatitis C drug on the market. The bad news: this remarkably successful drug costs US$1,000 for just one pill.
The drug, Sovaldi, was approved by the United States’ Food and Drug Administration in December 2013. Whereas most hepatitis C medication must be combined with another drug – interferon, a substance that is produced naturally by the body’s immune system and can be used synthetically to fight infection – in order to treat all the types of the virus, Sovaldi is the first pharmaceutical that can fight hepatitis C all by itself. There is no vaccine for hepatitis C, but the virus can be cured with medication in 50 to 80 percent of patients. Sovaldi is even more effective: curing 90 percent of patients within the first 12 weeks of treatment.
During its first quarter on the market at the beginning of 2014, Sovaldi has proved extremely popular. Gilead Sciences, the drug company responsible for creating and selling Sovaldi, has seen huge profits since the start of the year: making more than US$2 billion on Sovaldi in just three months.
Some have referred to Sovaldi’s strong sales as the best drug introduction in history, but plenty of advocates in the drug and health care industries are expressing fear that the extraordinarily high cost of Sovaldi might detract from the products usefulness. An editorial in the New England Journal of Medicine called the price of Sovaldi “breathtaking,” and questioned the ability of the drug to achieve meaningful success in the fight against hepatitis C. The editorial explains that with Sovaldi costing US$1,000 per pill, the United States would need to spend billions to treat even half of the hepatitis C patients around the nation – a virtual impossibility due to the U.S.’s already overburdened health care system.
Public health care spending is a concern because many hepatitis C patients do not have the means to fund expensive treatment on their own. The New York times reports that over half of all people suffering from hepatitis C are either in jail, are veterans, do not have insurance or are beneficiaries of public health money through a plan such as Medicaid. Hepatitis C is a blood-borne virus that leads to chronic infection, liver scarring and possibly liver failure or cancer. Because the virus is primarily transmitted through sharing needles or using unsterilized surgical equipment, drug users or those who don’t take precautions when getting a tattoo or other medical procedure are the most likely to get hepatitis C – and the least likely to be able to afford treatment.
In other parts of the world, Sovaldi’s success may likewise be overshadowed by the high cost of the drug. The World Health Organization estimates that around 150 million people across the globe are currently suffering from hepatitis C, with up to half a million dying of the disease every year, mostly due to complications of the liver. Although curative medications are effective, many hepatitis C sufferers live in developing nations where access to treatment and even accurate diagnosis may be difficult to find or afford. Central Asia, East Asia and North Africa contend with more hepatitis C sufferers than any other parts of the world, but these areas might not be able to afford Sovaldi: patients are recommended to take one Sovaldi pill per day, a pill that comes with the price tag of US$1,000. Twelve weeks of treatment – the recommended time frame for curing a standard case of hepatitis C – would cost US$84,000, and to tackle more difficult strains of the virus, 24 weeks of treatment at a cost of US$164,000 would be required.
Some opponents of Sovaldi’s pricing scheme have already taken action to share the drug’s treatment potential with the international community, without its extreme price tag. The Initiative for Medicines, Access and Knowledge, a New York legal group, is currently trying to prevent Gilead Sciences from putting a patent on Sovaldi in India. If the Initiative is successful in these attempts to block a patent, medical researchers in India may be able to develop a cheaper yet equally effectual form of a Sovaldi-esque hepatitis C drug which could then be sold at lower prices in India and other developing nations.
In response to accusations that the cost of Sovaldi is too high, Gilead Sciences has said that its pricing is an accurate reflection of the drug’s treatment abilities, and that Sovaldi may actually cost less than hepatitis C treatments currently on the market. Whereas Sovaldi is effective on its own, other hepatitis C drug regimens rely on dual treatment from both interferon and another type of antiviral medication – and according to Gilead, that dual regimen would take longer to cure the virus and in some cases end up costing more. Gilead has also said that it will reduce drug prices for qualifying patients, as well as work together with some insurance companies to create less expensive pricing schemes.
Despite criticism of Gilead over Sovaldi’s high cost, most experts agree that the drug company’s profits will continue to rise. Sovaldi has proven more effective than any other hepatitis C drug on the market, and what’s more, it doesn’t come with debilitating side effects – unlike some traditional forms of hepatitis C treatment. Before 2012 the most common form of treatment involved a weekly shot of interferon as well as a daily dose of an antiviral tablet; however, this therapy lead to severe side effects in some patients, including nausea, headache, vomiting and other flu-like symptoms, as well as depression and anemia.
Sovaldi also seems to work better than similar combination therapies. In 2011 the U.S. Food and Drug Administration approved Incivek, a one-pill hepatitis C treatment that was later accused of having too many side effects and a cure rate that was too low – accusations that Sovaldi has managed to avoid, and drug makers clearly think that the health care industry will pay much, much more for a much better product.