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148588 tn?1465778809

$1,000 per Pill

http://finance.dailyherald.com/dailyherald/news/read?GUID=26295196

In a series of letters to be sent to state Medicaid directors starting today, AIDS Healthcare Foundation (AHF) President Michael Weinstein will ask the state directors to block Gilead Sciences’ new $1,000-per-pill Hepatitis C drug Sovaldi (sofosbuvir) from inclusion on their respective state Medicaid and other drug formularies. The drug was approved by the F.D.A. on December 6, 2013 and Gilead immediately announced that it would price the drug at $84,000 for a twelve-week course of treatment—or $1,000 per tablet—making it one of the most expensive drugs ever marketed. Suggested treatment guidelines also require that Sovaldi be used with another drug, ribavirin (a nucleoside inhibitor), further adding to the cost of the prohibitively expensive course of treatment.

“When is enough, enough? At $1,000-per-pill, Sovaldi is priced 1,100% more than Gilead’s most expensive AIDS drug, Stribild, its four-in-one AIDS drug combination, which was priced at $80 per pill a year ago when it came to market,” said Michael Weinstein, President of AIDS Healthcare Foundation. “At that time, Stribild’s price was 35% more than Atripla, the company’s best selling combination HIV/AIDS treatment, and made Stribild the highest priced first-line combination AIDS therapy. Now, Gilead has set a new benchmark for unbridled greed with its outrageous price for Sovaldi—a price that some pharmacy industry sources suggest represents a retail markup of 279,000% over the cost of actually producing the drug.”

In his letter to state Medicaid directors, Weinstein wrote, “Gilead is charging a higher price for this drug even though the cost to produce it is small. According to industry reports, Gilead produces Sovaldi for approximately $1.00 per gram (with only 10 to 30 grams needed to successfully treat patients with Hepatitis C).1 This represents a retail markup of over 279,000%. (NOTE: With only 10 to 30 grams of Sovaldi needed for successful treatment, the difference from the $30 production cost for Gilead’s full course of treatment—30 grams x $1.00 per gram—to $84,000 for the 12-week treatment program represents a retail markup of 279,000%.)

Weinstein’s letter to state Medicaid directors also reminds them that, “Gilead did not pay to research and develop Sovaldi. In 2011, it purchased Pharmasset, the company that had already developed the drug, for $11 billion in cash. The pricing of Sovaldi is being driven by Gilead’s desire to recoup its investment in Pharmasset, and assumes it can accomplish this by charging Medicaid and other taxpayer-funded programs whatever it wants.”

“Gilead is now seeking a bonanza on a financial investment—not on its R&D costs of a drug—by gouging cash-strapped government programs, essentially treating states like its own private—rigged—stock market,” added Weinstein. “With regard to Sovaldi, it’s time we stopped thinking of Gilead as a drug company and recognize them for what they are here: a pharmaceutical hedge fund bent on exploiting government-funded drug programs like Medicaid and ADAP at the expense of the American taxpayer.”

AIDS Healthcare Foundation (AHF) is deeply concerned about the fiscal impact of new FDA approved Hepatitis C medications on your Medicaid program, and the effect of that impact on the health care of people in your state. The first of these new medications, Gilead Sciences’ Sovaldi, is exorbitantly priced at $1,000 per pill.

While the approval of Sovaldi and similar treatments is a welcomed advancement for people in need of better treatment for Hepatitis C, the unjustifiably high price manufacturers are seeking to charge for these medications will unnecessarily drive up health care costs and limit access to potentially lifesaving care. Therefore, AHF urgently requests that your Medicaid program deny Sovaldi and other new Hepatitis C medications from being added to your state formulary until these drugs are made affordable.

AHF believes that the price Gilead is charging for Sovaldi is not remotely justified. For one, it is exponentially more expensive than medications for other severe chronic conditions. For example, Gilead’s own Stribild, a costly new four-in-one combo treatment for HIV/AIDS, is $80 per pill. At $1,000 per pill, Sovaldi costs 1,100% more than Stribild, the most-expensive AIDS combo drug on the market.

In addition, Gilead is charging a higher price for this drug even though the cost to produce it is small. According to industry reports, Gilead produces Sovaldi for approximately $1.00 per gram (with only 10 to 30 grams needed to successfully treat patients with Hepatitis C).2 This represents a retail markup of over 279,000%.

Finally, Gilead did not pay to research and develop Sovaldi. In 2011, it purchased Pharmasset, the company that had already developed the drug, for $11 billion in cash. The pricing of Sovaldi is being driven by Gilead’s desire to recoup its investment in Pharmasset, and assumes it can accomplish this by charging Medicaid and other taxpayer-funded programs whatever it wants.

Private drug plans have taken notice of these facts—along with community outrage over the cost of Sovaldi—and have delayed paying for the drug until Gilead agrees to significantly lower the price. For example, Express Scripts, CVS Caremark, Catamaran Inc., and Aetna are all taking steps to block or delay the use of Sovaldi.3 Given this, AHF believes it is imprudent for your state to cover this medication until a better price is available.

Most critically, by taking action to ensure a better price your state will not be putting patient health at risk. There are alternative (and less expensive) treatments for Hepatitis C already available. In addition, Gilead’s patient assistance program provides the treatment for free to people making less than $100,000 a year who cannot access it elsewhere. These steps, while not ideal, will ensure patients continue to receive the care they need until newer medications are made affordable.

Once again, AHF urgently requests you to take action on this matter by denying Sovaldi and other unjustifiably high-priced Hepatitis C medications from your drug formulary until an affordable price is available.
15 Responses
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148588 tn?1465778809
I guess it boils down to what level of healthcare should be available to everyone and what has to be limited by simple lack of resources and availability of specialists. The procedures el speaks of will always be limited by time and specialists. How do you factor in Gilead's $11 billion purchase of $1/gram Sovaldi from Pharmasset when part of that price tag was shareholder profit, part was actual R&D, part was physical assets (plant, employees, etc.) ? Our views are shaped by experience so let me add my anecdote.
My Peg/riba treatment cost me a $50/month co-pay for 5 months. Factor in my part of my insurance premiums during that time and the total cost was less than the price of a day and a half of Sovaldi. At the same time an uninsured, self-employed contractor I worked with was paying $5,000/month out of pocket because he had a 'pre-existing condition' and couldn't get insurance.












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Helpful - 0
163305 tn?1333668571
And everyone says, " who cares how much it costs, my insurance will pay."
But who lands up really paying ???
Helpful - 0
1310633 tn?1430224091
Haven't been in hospital since March 22nd, 2012.

After 19 years of spending 2-3 days/month+ in the hospital (anywhere from 30-50 hospital days a year), undergoing countless cystoscopy's, PCNL's, after passing well over 10,000 kidney stones varying in size from 0.5mm-8.0mm and having still larger ones surgically removed... I'd spend the $$$ all over again.

Best $$$ ever spent, IMO.

It's changed my life. I used to be "LMNO the kidney-stone guy".

Now I'm just "LMNO the guy".

Again, off topic, but it makes me smile talking about it;-)
Helpful - 0
1310633 tn?1430224091
Point well made.

I'll say this... the treatment for my ailment, cost well over $280,000.

*1 complex left-side nephrectomy
*3 weeks in hospital and 4 follow-up surgical procedures to correct lingering issues
*16 weeks post-surgical care

Cost: $280K'ish

Worth every penny.

If you're sick, and you want to get better, you'll pay the tab.

All of that is off topic, I know, but still...;-)
Helpful - 0
Avatar universal
While $84K for treatment may sound expensive (and it is), I can assure you my treatment cost much more.
Helpful - 0
Avatar universal
So it's OK for these large Pharm companies, that have never actually done any research on a drug and merely made a speculative investment in a company that did, to target taxpayer money to recoup the money from their speculation?

I'm not sure where the difference lies on who footed the r&d bill. Happens all the time, look at how many biotech firms have been bought out by large pharma companies for their pipeline drugs.

Have you actually compared the price tag of this $1000 pill treatment to older treatments (in my case lasting 72 weeks), that had only a 50% chance of success?
Helpful - 0
1310633 tn?1430224091
I think you misconstrued...

Sounds fair to me that they're giving free treatment to those that make less than $100K/yr.

The $1,000/pill thing is abhorrent.

Helpful - 0
148588 tn?1465778809
I guess you're a fan of socialized medicine.
Helpful - 0
148588 tn?1465778809
So it's OK for these large Pharm companies, that have never actually done any research on a drug and merely made a speculative investment in a company that did, to target taxpayer money to recoup the money from their speculation?
Helpful - 0
1310633 tn?1430224091
"...Gilead’s patient assistance program provides the treatment for free to people making less than $100,000 a year who cannot access it elsewhere...."

Sounds pretty fair to me.
Helpful - 0
317787 tn?1473358451
This is awful! I had no idea it was going to be so expensive.  Everyone has been looking forward to this new drug.
I thought, originally they were trying to recoup their research funding.
It seems criminal to me that they can charge this much.

Thank you for the article.
Helpful - 0
Avatar universal
This is ridiculous. And this is what needs to change! Ridiculous!
Helpful - 0
148588 tn?1465778809
How much do you want to bet it's already been smuggled over to Mumbai or Shanghai, been reverse engineered, and is being produced for less than a dollar a gram?
The greed will stop when people realize they can buy a plane ticket for the price of one pill and be cured without even using Medicaid or their health insurance.
Helpful - 0
163305 tn?1333668571
Holey Moley when does the greed stop ??
Helpful - 0
148588 tn?1465778809
“Gilead is now seeking a bonanza on a financial investment—not on its R&D costs of a drug—by gouging cash-strapped government programs, essentially treating states like its own private—rigged—stock market,” added Weinstein. “With regard to Sovaldi, it’s time we stopped thinking of Gilead as a drug company and recognize them for what they are here: a pharmaceutical hedge fund bent on exploiting government-funded drug programs like Medicaid and ADAP at the expense of the American taxpayer.”


Thanks to rivll for the link.
Helpful - 0
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