HCV drugs are priced out of reach and out of control.
-- Michel Sidibé, UNAIDS
MELBOURNE, Australia -- Treatment activists at the 20th International AIDS Conference held a die-in to protest the exorbitant pricing of Sovaldi (sofosbuvir), Gilead's new hepatitis C virus (HCV) drug.
As Gregg Alton, Gilead's Executive Vice President of Corporate and Medical Affairs, spoke, activists brought him a liver on a silver platter while chanting "Pills Cost Pennies, Greed Costs Lives," "Shame, Shame, Shame," and "Pharma Greed Kills." Their signs said, "Wanted: Crimes Against Access," "Hep C Criminal," and "Gilead Kills" as the O'Jay's "For the Love of Money" blared in the background.
Worldwide, at least 150 million people have chronic HCV. Although curable, it kills 500,000 people each year. Hepatitis C is prevalent among people who inject drugs, and widespread in low- and middle-income countries (LMICs).
A few months of treatment with new oral drugs (including Sovaldi) can cure HCV. But Gilead charges US$84,000-168,000 for Sovaldi in the United States; prices across Europe are similar. Sovaldi is unavailable and unaffordable in LMICs, and access in high-income countries is limited.
Sovaldi must be used with other hepatitis C drugs, making treatment even more expensive. But these HCV drugs can be mass-produced generically for just a few hundred dollars for an entire course of treatment, according to researchers from the University of Liverpool.1
Alton defends Sovaldi's price, claiming that treatment with Sovaldi is cheaper than a liver transplant. But most people with hepatitis C virus have not even been diagnosed, and have no hope for a transplant.
"Extortionate pricing will kill people, no matter what the illness -- HIV, hepatitis, or cancer," said Edo Agustian, an Indonesian activist coinfected with HIV and HCV.
Myths and Facts About Gilead's Sofosbuvir Pricing
MYTH: "The drug has to be priced this high for Gilead to recoup its investment."
FACT: Gilead has already sold at least US$3 billion of sofosbuvir; sales will soon exceed its investment.
MYTH: "Gilead's price is 'cost effective,' because it is cheaper than a liver transplant."
FACT: Almost 500,000 people die each year from hepatitis C; most people living with hepatitis C around the world will never even have the hope of a liver transplant. A cure should not be held hostage by high prices. Medicines should be priced so that people who need them can have access -- not priced based on a comparison with other interventions.
MYTH: "Gilead has already done so much to increase access to sofosbuvir for the world's poor -- it has dropped the price as low as it can go."
FACT: Sofosbuvir is priced at US$1,000 per day in the United States. Gilead could make its investment back through volume of sales while making the drug affordable. Health economists estimate that sofosbuvir could be produced generically for less than US$1 per day -- a model that includes reasonable profit margin for generic drug makers.
MYTH: "Sofosbuvir will be available everywhere."
FACT: Gilead is making licensing agreements that limit access and keep prices too high for most of the world.
MYTH: "Governments can pay for sofosbuvir."
FACT: Even in high-income countries, Gilead's price is completely unaffordable. Reports show that paying for sofosbuvir will bankrupt health care and education budgets.
- Hill, A, et al. Minimum target prices for production of treatment and associated diagnostics for hepatitis C in developing countries (Poster LBPE12). International AIDS Conference; 2014 July 20-25; Melbourne, Australia.