Oh - may have read that wrong - as in, you are suggesting insurance will encourage us to mix with such a stick? Not sure they will want to pay for the new parts for the mixture though - at least at first. But agreed - for the industry, as evidenced by stock prices, PI's seem to be where the money is. I'd like to see better interferon, and ultimately, a vaccine, but who knows...
Agreed - on assumption 4, I should have written - "will have a price for patients/insurance as high as interferon". The cost to manufacture has very little to do with price, price is more of a function of supply, demand, and earning a sufficient return on investment for the trial costs, and the massive risk of failure in pharma (most drugs never make it). I'm also expecting swizzle sticks for quite some time, I think there is some false hope from many that even if these drugs are approved, they will instantly have access to them.
Assumption #4 doesn't track. It's hard to figure any PI being as expensive to produce as IFN. India is producing the AIDS meds for pennies and the real cost of VX950 and SCH50304 will probably be on the same order. Doubtless Schering and Roche will inflate the price for the first few years to recoup the millions that have been extorted from them by the 'patent holders' of the HCV virus (i.e. the company that bought the company that bought the company that bought Chiron) - but hey, that's venture capitalism. In this case the fault doesn't lie with big pharm but with international patent law and our own CDC that gave those patent rights away in exchange for the promise of a vaccine that never happened.
"What will insurance companies do when the first new cocktail drug arrives?"
Give us all a swizzle stick. It's more profitable than developing IFNs that work for everyone.
It seems to me, that insurance companies in the US are going to be the key players in this one. They have to be, otherwise, pharma can just set whatever price they want - and that's not the way it's going to work.
I think the cost will be very high to be honest, because the trials are taking so long. The only thing I can think of that may limit the cost, is competition. If the first PI winner goes in too high, will that backlash against them when the next PI comes along?
I'm not too sure on the answer. But I think the Pharma companies are getting more savy, and they recognize that consumers are more capable of shopping around accross borders, so that this time, the price that is set in US may not be too different from the price elsewhere. US is the big money market, so I suspect big pharma would sooner not sell to the UK government, or another government, than see that sale damage the price they can obtain from the insurance route in the US.
I think this is a very good question. I live in the UK with socialised healthcare and they are pennypinching with every little thing. It is quite feasible that they would work out some way of limiting the use of the new drugs while trumpeting 'free healthcare for all at the point of use'. I think they'll finesse things so that enough of us die off before they have to fork out to treat the ones that are left.
What will the new drugs cost though? That's the question. It's a big assumption to say that they'll cost as much as peg don't you think?
One more assumption (a biggie I guess):
8. Trials only demonstrated an improvement of SVR rates for Geno 1's, if treatment was for 48 weeks.