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Government Impact of Hep C Drug Price Tag

Nicole Cutler L.Ac. April 2, 2014

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If Medicare must absorb the bulk of Sovaldi’s cost, what long term effect will Hepatitis C treatment have on this federally funded program?
Government Impact of Hep C Drug Price Tag

Gilead Sciences Inc. has developed Sovaldi, an FDA-approved, once-daily pill that has dramatically improved the odds of beating Hepatitis C. Although millions of people could likely benefit from Sovaldi, Gilead has priced this medication above and beyond what most would consider to be a reasonable fee. Gilead insists that Sovaldi’s cost is justified, but the stress it will put on America’s struggling healthcare system is yet to be realized.

Millions of dollars and many years of research and development are spent by pharmaceutical companies to find the best cure for what ails us. When it comes to finding more effective and safer treatments for Hepatitis C, the race has heated up considerably over the past decade. From a business perspective, it seems reasonable to apply the law of supply-and-demand to a valuable product. Unfortunately, this economic principle puts those who must pay for a potentially life-saving medicine at the mercy of the winning pharmaceutical company.

Approved by the FDA in December of 2013, Sovaldi appears to be extremely effective against Hepatitis C. The prior standard-of-care was a combination of Incivek, interferon and ribavirin that had a cure rate of 75 to 80 percent for treatment-naive patients in 24 weeks – but with some severe, toxic side effects. By replacing Incivek with Sovaldi, the cure rate jumped up to 90 percent, was accomplished in just 12 weeks, and has virtually no side effects.

Obviously, the demand for Sovaldi is high, and Gilead is meeting that demand with an asking price of $1,000 per pill. For a standard 12 weeks of treatment, that equals $84,000 for one drug of a three drug treatment regimen. If everyone in the U.S. with Hepatitis C were treated with Sovaldi at its list price, it would cost an estimated $227 billion. For comparison sake, approximately $260 billion is spent in America each year for all drugs.

There are several circumstances that make the high cost of Sovaldi a significant burden to the federal government:

  • An estimated 75 percent of adults with Hepatitis C are baby boomers, meaning they were born between 1945 and 1965.
  • Excluding several instances that can allow people to qualify earlier, American adults are eligible for Medicare when they turn 65 years old.
  • For the past four years, many of the oldest baby boomers are covered by Medicare.
  • As more baby boomers are diagnosed with Hepatitis C, Medicare is likely to be processing an increasing number of Hepatitis C treatment claims.
  • Sovaldi is covered by privately-administered Medicare Part D (the Medicare Prescription Drug Plan) for patients over 65 years old.
  • As more baby boomers with Hepatitis C turn 65 years old, Medicare will be the primary program contending with Sovaldi’s cost.

The system-wide costs associated with the estimated 4.1 million Americans infected with Hepatitis C are staggering. Even if negotiated to half the current price, treating every Hepatitis C patient in the U.S. with Sovaldi would cost the system about $172 billion. The Hepatitis C community is grateful for Gilead’s amazing once-a-day pill. However, the American healthcare system might not be prepared to deal with the fiscal reality resulting from Sovaldi’s high price tag.

http://www.bloomberg.com/news/2014-03-05/hepatitis-c-drug-price-limiting-state-medicaid-approvals.html, Hepatitis C Drug Price Limiting State Medicaid Approvals, Retrieved March 30, 2014, Bloomberg L.P., 2014.

http://www.forbes.com/sites/natesadeghi/2014/03/27/breaking-the-bank-the-innovation-cost-paradox-of-us-healthcare/, Sovaldi and the Cost-Innovation Paradox, Nathan Sadeghi-Nejad, Retrieved March 30, 2014, Forbes.com, 2014.

http://www.reuters.com/article/2014/03/21/us-hepatitis-egypt-gilead-sciences-idUSBREA2K1VF20140321, Gilead offers Egypt new hepatitis C drug at 99 percent discount, M. Fick, B. Hirschler, Retrieved March 30, 2014, Thomson Reuters, 2014.

http://www.sciencedaily.com/releases/2013/04/130426211102.htm, Attention Baby Boomers: Get Screened for Hepatitis C, Retrieved March 30, 2014, ScienceDaily, 2014.

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HepatitisCentral.com provides information regarding hepatitis and liver disease. Comments are available to the community in order to discuss these topics and obtain answers to questions through community members. The Editors at HepatitisCentral.com will not be responding to questions or comments posed in article comments.

  • Jeff C.

    You stil have to take interferon and ribavirin along with the Incivek…No Thanks!

    • Jeff C.

      typo; still

      • Jeff c.

        Wow, I really messed this up! I meant to say: You still have to take interferon and ribavirin along with the Sovaldi….No Thanks! This article said this treatment had virtually no side effects. C’mon man, how do you not have horrible side effects being on interferon and ribavirin? My guess is this is just another lie by the

        • Jeff C.

          another lie by the pharmaceutical industry.

          • Duane McGorman

            When I took interferon and ribavrin, the VA told me that I had cleared Hip C; however, Dr. Gendron, of the Iron Mountain VA Medical Center, outright had lied to me. I still have it. No doubt, Dr. T. Gendron was was actually working for the pharmacy company; not for me.

          • Dave R

            I had to take 12 ribavirin tablets a day and one (Pegasy) interferon shot a week for a year then the virus (geno type 1) came back and the doctor put me on the same dose for a two year regament I’d trade twelve weeks to three years any day.

        • Myron

          I will tell you what jeff since you are so smart just pull a cure from your butt and die with it.

          • Jeff C.

            Myron, I realize that no one said it was going to be easy. The point that I’m trying to make is treatment without interferon. A good example of this is Bristol-Myers Squibb Co. and there development of daclatasvir and asunaprevir (look into it). It is a very small majority of people that aren’t affected or can tolerate the terrible side effects of interferon (ribavirin).

          • Jeff C.

            Oops! I did it again the word is effected not affected. It is a very small majority of people that aren’t effected or can tolerate the terrible side effects of interferon.

        • Lisa Cohen

          you do not still take interferon and ribavirin w this new drug

          • Jeff C.

            Lisa, from what I understand Sovaldi is replacing Incivek with this treatment. You still have to take interferon and ribavirin with the Sovaldi.

          • Mike Monday

            I just got approval from my insurance co. to start treatment. It depends on what geno type u have whether you have to take the interferon with it or not. I have geno type 3 and don’t have to take interferon, but l have to take it for 24 weeks instead of the normal 12 week treatment because I’ve been treated with interferon twice in the past 20yr. Find a good Dr. and find out what your geno type is and he can tell u if you will need interferon or not. Certin type’s are harder to clear up than others that’s why some have to still take interferon with it but the treatment will be much shorter than treatments in the past

          • mikev

            My GI guy told me I will have to take all three and the side effects will much worse than I had with only interferon and riba ???? confused.

        • Jo

          Having just cleared the Hep C virus in a Drug Trial the answer is NO, you do not have to take other toxic drugs. I did a 12 week session with Lipidesvir and Solvaldi (aka Sofospavir) and had no side effects. The drug is astounding! I was type 3 and a relapser.

          • Chris M.

            Amazing! I`m going to talk to my Dr. about this treatment. I`m so happy for you!

          • eric brown

            Good for you, question what do Now ? Eric

        • Chris M.

          You`ve got that right. Interferon & ribavirin about took me out. My white blood count got below 500. I thought I would never recover, I had to stop treatment. The lies not taking into consider human life make me sick.

  • Wy Alan

    Okey. The long awaited miracle pill designed to almost eradicate the toxic Hep. C is finally approved and available for a measly $1,000 a pill! Can 4.1 million Hep C suffers say “greed for grief. Wy Alan.

  • Kevin Harkin

    As part of a study group, I took Bristol Myers Squibb’s all oral treatment for 12 weeks. The results were fantastic and within 3 weeks I was undetectable. It’s been a year, and I’m still undetectable. In fact, everyone in my study group is considered cured. There were zero side-effects, none at all. All that’s left in my blood are the antibodies. I don’t understand why these medications haven’t been released to the public. I was just lucky that a friend referred me to this study group.

    Before I was cured, I took mega-doses of “Milk Thistle”, “NAC” “Alpha Lipoic Acid”, Himalaya’s “Liver Care” “Dandelion Root” and “Licorice Root”, plus ate as much organic that I could afford. As a result, my liver enzymes went from extremely high to normal within three months. As I said, I didn’t take the recommended dosage, I took about 2-3 times the recommended dosage. But, of course, the oral cures are the way to go. I hope they’re approved soon and I hope the insurance companies will pay for them.

    Sincerely,
    Kevin

  • Smiley

    Husband of a friend is taking interferon, ribaviron and solvaldi, he just started last week & has the same side effects as I did when I did the triple-cocktail treatment with victrlis 2 years ago. I’m cured, no trace of hep C & I’m confident he will be too but there are side effects…. no way around it no matter what they say. I took large doses of milk thistle, tumeric, biotin and Sam-e before & during treatment, still lost my hair. white counts went sub-zero so had to take a neupogen shot a couple times a week to boost them but am hoping the different cocktail won’t affect him that way.

  • Mike

    My wife and I were both diagnosed wiht Hep C,she over thirty years ago. Me about two years ago although I know I have had it longer.We have Geno type 2,she was able to get treated at A neighbor hood clinic,I was to be treated after.We used Medicare and grants.I was to be next,then the doctor who had treated over 200 patients,with over A 95% cure rate was transfered out of state.
    I went for A clinical trial here in Las Vegas,and was told I had the easy one to cure they wanted only geno 1
    If I had deveoped A new drug with life saveing potintial I would deal in volume instead of just the richest 2%

  • Diann Peterson

    Greed…Pure and simple. I despise them.

  • Diann Peterson

    I also read that they are selling it much cheaper to companies out of the country. It’s hard to believe. I have had this virus for about 35 years old and soon turning 60. I keep wondering why they want me to get another liver biopsy that was excruciating when they know my insurance will not pay? I’m just not up for going through that when all I will hear at the end of the day is that they are sorry about my crappy HMO insurance. I am heartbroken.

    • Golden Dragon Guy

      You don’t need a needle biopsy. I have had five of them, and although they were uncomfortable (not excruciating), they are no longer needed to identify very low or very high fibrosis and cirrhosis. That can be done with FibroScan, an acoustic probe instrument that is completely non-invasive and painless and has no dangers. Health care organizations are getting these machines now that the FDA has finally approved them.

  • Gettingoverit

    Ivebeen on the sovaldi with the interferon and ribaviron and have little side effects. Yes it’s hard to believe, but I’m six weeks in now and have only experienced headache, and moodiness. Which to me is worth it. And I’m having good results so far. Six more weeks to go!

    • Jeff c.

      Fantastic! All the best to you.

  • cbarker

    I was on this clinical trial with GS of ledipasvir (LDV) 90 mg sofosbuvir (Solvaldi) & Ribavirin. There are no bad side effects. & I’m considered cured. there are other drugs now on the market that have an incredible cure rate.

  • Share gull

    This drug company and like this are thief who are robbing patients under legal boundries. Govt should ban them advertising sovaldi in internet. They give the patient fake hope and robbing them.

  • Myron B

    Jeff C., I am currently taking this regiment Solavaldi 400mg and ribavirin 1200mg, per day, and no pegulated interferon and no incvek. I am into my 3rd month with absolutely no side effects, except no headaches, no sore muscles or pain at all. My viral load was in the 100,000. at the start and now almost nonexistent. Due to a head injury in 2008 I have a medically controlled seizure disorder with 1200mg of keppra per day as well and interferon brings on seizors that is why I was not able to start taking this until February this year. My doctor is Dr. Shiftman at the Liver Instute of Virgina, Newport News.

    • Jeff C.

      Myron, It’s a challenge to keep all the info straight on these new treatments, but I’ll keep learning. I wish you all the best, good luck to you!

    • MHCVa

      Myron, My doc is Dr.Schiffman & April Long, also! They are great!

  • mike

    I just started the Sovaldi and I have to take olisy and ribavirin but the cost is a lot higher than $1,000 a pill with the 3 drugs copay was right at $6,000 and that’s supposed to be 5% but No interferon

    • scott

      I have Medicare Part D, a new liver 3 years ago that I’d like to keep, and desire to try the Sovaldi, but the co-pay is over $6.000.00 per month. Where does the avg. person come up with that kind of money? Though I make too much to qualify for any kind of assistance, I don’t have the extra 6K lying around every month, either…Never have any of my docs suggested that Interferon be used also- this is some kind of pharmacutical b.s., perhaps the kickback plans w Interferon cos. are enriching certain people in the industry? Hoping for a cheaper product or dramatic price decease so we can ALL be cured.

      • mike

        Scott I forgot I didn’t think I would qualify but got talked into applying and I did

  • Greg N

    22 Months of interferon and ribavirin 98 thru 99. 11 years of lactulose, Liver transplant 8/18/2013 Hope to be treated this year for the Hep-c. Do you have more energy after treatment?

  • Wendy

    I took the gilead drug and was cured! No side effects and no interferon. I was part of a study. It worked!!!

  • mike 1951

    For those of you that think Sovaldi is the one medication that will cure Hepatitis C, read the following. I was in treatment before Sovaldi was approved, the treatment failed due to peginterferon issues. My GI informed me that I would not be able to treat with Sovaldi because pegineterferon is still used in the treatment. This may be due to the Gen type 1A . other gen types may differ.

    Patient Information
    SOVALDI™ (soh-VAHL-dee) (sofosbuvir) tablets

    Read this Patient Information before you start taking SOVALDI and each time you get a refill. There may be new information. This information does not take the place of talking with your healthcare provider about your medical condition or your treatment.

    SOVALDI is used in combination with other antiviral medicines. When taking SOVALDI with ribavirin or in combination with peginterferon alfa and ribavirin you should also read those Medication Guides.

    The information in this Patient Information Leaflet talks about SOVALDI when it is used with ribavirin and in combination with peginterferon alfa and ribavirin.

    • mike

      I also have type 1a, this is my 3rd time on meds 1st time interferon and ribivian it was when it just switched to the peginterfion I had to mix powder to give shorts but anyway at 20 weeks Dr took me off telling me that the meds were going to kill me. 10 years later I went back on Incevek, interferon and ribivian with a new Dr. I got thru with transfiusions and procirt. Hep c cleared at 28 weeks I was on meds for 48 weeks but at 6 week check after off meds hep c was back. Now I’m on Sovaldi, Olysio, and ribivian. no interferon and saw far only headaches. Anyway find a new DR and don’t give up

  • K-T

    Unbelievable! This pharmaceutical company cut the cost by 3/4 and it would still make a ton of money and faster. I went threw the 3 drug program and payed ( side effects)dearly, still paying too. At that cost though it is out of reach for most or Medicare should say we will pay 200 per pill period.

    • K-T

      Stop trying to make a living from people dying

  • Mike

    I saw on the news that Sovaldi only cost $900 a month in eygpt can anybody say travel agent!

  • Paul M

    Paul M.
    My wife contracted Hep C from a transfusion in Asia thirty years ago. After she became eligible for Medicare, rather than start treatment immediately, we continued to wait several months for this new drug ‘Sovaldi.’ We heard that with sovaldi, she wouldn’t have to take the interferon with its infamous nasty side effects.

    When the time came to start treatment, however, we found out that insurance would not cover the treatment without interferon because her Hepatitis virus was genotype 6. Apparently type 6 wasn’t included in the sovaldi study…? She started treatment on 1/24/14 with ribavirin, interferon and sovaldi. In the 3rd week promacta was added to help with her blood count.

    I gave her the interferon shot ‘pro click’ injections on Friday evenings. This gave her the weekend to recover. Side effects included flu-like symptoms and some tiredness and weakness for the next two days. The side effects were not as bad as we had feared they would be. By the fourth week the virus was undetectable.

    The most significant side effect was anemia. Because of this in the sixth week her ribavirin was cut from 1000mg to 200mg per day. On March 1st we added shots of procrit once per week to help boost her blood count. By March 3rd she had to have a blood transfusion. Her CBC (compile blood count) lab tests continued to show her blood counts declining. We had another transfusion later in March.

    On Wed. 4/9/14 we were told to stop the treatment completely just 9 days short of the 12 week treatment completion date. We did another transfusion on 4/15. We will do the next CBC lab test on Monday 4/21 and will be meeting with the doctor on 4/22 to see where we go from here with her treatment.

    Our hope is that she is cured, having taken the triple cocktail of drugs for as long as she did. In spite of how this narrative may sound, I was pleased at how well she tolerated the treatment in the beginning. She had been told that she probably would not be able to tolerate the side effects of the interferon and ribavirin. Hopefully the sovaldi will turn out to be highly effective against the genotype 6 Hepatitis virus and will have made the difference for her in spite of having to stop treatment 9 days early… Please wish us luck.

  • Quest

    Was in a trial for 8 weeks, only sovadi and lepasiver, NO RIBA, NO INTERFERON, I am still SVR 9 months! ONLY 8 weeks!

  • theresa

    I am currently on the sovaldi and ribavirin and it is true – no side effects!!!! been on since 3/8/14. I will be taking it for 6 mos.

  • TROTLINE13

    IT”S LIKE AN AIRPLANE FALLING FROM 4000 FEET AND I OWN ALL THE PARACHUTES! PEOPLE COME TO THE DOOR AND I SAY ONE HUNDRED THOUSND DOLLARS FOR A PARACHUTE,WHAT NO MONEY WELL I GUESS YOUR GO’N DOWN WITH THE PLANE! IF YOU HAPPEND TO HAVE A GUN WOULD YOU JUST TAKE A PARACHUTE?

  • eric brown

    THANKS por. the. Intel — ps i wish the.best of. Health. God bless. Eric

  • Dave

    I am on my 10th week on Sovaldi/Ribavirin/Interferon. Other than a rash and some other minor side effects, it has been nothing as bad as I had feared after reading horror stories for months. DRINK ATLEAST A GALLON OF WATER A DAY WITHOUT FAIL!! Compared to dying a painful death from cirhossis or having a liver transplant, I am soo glad I tried this first. My bloodwork at 8 weeks looks great. Ten years clean May 5, 2014, started treatment April 22, 2014. Looking forward to completing July 15!! Dont let fear of the unknown keep you from trying treatment!!

  • feroz qaiser

    FRNDZ,
    my name is feroz . i am 26 years old male from pakistan i have diagnose hep c with geno type 3 almost 2006.i have treated interferon,pegysis,and peg intron with ribaviron.but no responce ive comments.received till.now dr decided sovaldi tablets what do u think and give comments about products results and availabality in pakistan.

  • MHCVa

    Sovaldi (with Olysio) is working for me with little side effects and Thank God, Anthem will pay for it! But Gilead Rx, you need to get real and have compassion and lower the damned price!
    I am Type 1-A and started showing HCV Neg after three weeks of tx. I have one week to go of the three month regimen!
    If you are 1-A TYpe and can get funding, go for it!

  • MHCVa

    I forgot to mention. Hep C left my liver alone and instead, damaged my kidneys so bad I was looking at a possible kidney transplant. Now my kidneys are so much better! AMAZING. I hate that it costs that much but by gum, it was worth it!

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