For $50 (about R700)‚ patients around the world have been cured of the once deemed incurable disease hepatitis C. However, the same cure would cost $10,000 (R140,000) in the private sector in SA, but in the US the price is $100,000 (R1.4m).
New data released at the World Hepatitis Summit held in São Paulo‚ Brazil‚ this week shone a spotlight on the pricing of hepatitis C drugs, one of the most controversial areas of medicine pricing.
Speaking at the summit on Thursday‚ University of Liverpool pharmacologist Andrew Hill explained that the tandem of drugs‚ sofosbuvir and daclatasvir‚ used for hepatitis C [under the brand names Sovaldi and Daklinza, respectively] have widely discrepant prices in different countries. The two drugs cost about $78 in India‚ $174 in Egypt‚ $6,000 in Australia‚ $77,000 in the UK‚ and $96,404 the US.
In some countries‚ people who cannot afford the first-world prices of the medicines join together to make "international buyers’ clubs" and import generics from manufacturing countries.
Hill explained that manufacture of the drugs‚ the active ingredients‚ the packaging costs and a tiny profit margin came to about $50 per course. His study looked at 1,160 patients who imported the generic drugs in 88 countries. The cure rate was above 90%‚ almost the same rate as the original, expensive products.
His point was that generic drugs can provide a cure for about 70-million people with the hepatitis variants worldwide‚ but remain out of reach for most because of high prices. University of Cape Town hepatology Prof Mark Sonderup said doctors have treated more than 150 hepatitis C patients in Cape Town’s Groote Schuur hospital using the new drugs. Nearly all have been cured, in 12 weeks.
The two drugs are not licensed in SA but can be imported under a special permit. Sonderup estimates the drugs cost $10,000 in the private sector and in the public sector go for $1,000 for a 12-week course. He said there was "room for improvement in prices".
The hepatitis drug debate has really brought the global debate on medicine pricing into the spotlight‚ The Lancet Commissions Report on Medicines reported. It was estimated that treating all patients with hepatitis C in the US would cost $65bn over five years. The cost of $84,000 just for sofosbuvir in the US even led to an investigation by US Senate committee of finance.
Paying for these drugs has tremendous "budget implications" in high-income countries — but in poor countries‚ prices are "even more daunting"‚ said The Lancet report.
Sofosbuvir was invented at a university but brought to market by a private biotech firm with the skills to do so. The Lancet estimated it only cost them $200m to do this. The firm was bought by Gilead Sciences for $11bn.
The Lancet Essential Medicines report revealed that "within one year of introducing [sofosbuvir]‚ Gilead Sciences had recouped the initial expenditure of $11.2bn; the patent will not expire before 2024". This patent on sofosbuvir means prices will not come down for the cure in every country even though Gilead has recouped its investment.
In SA‚ the Treatment Action Campaign has called for discussion and law changes where medicine patents render life-saving medicines out of reach‚ especially where patents are extended in SA beyond 20 years, as can be the case.