Gilead Sciences made a breakthrough in treating Hepatitis C – a drug called Sovaldi back in the year 2013. The price of the drug was about $ 84,000 for a 12-week treatment - $ 1,000 per pill.
In 2014, the bio-tech giant released an even more effective drug, Harvoni, which had almost no side effects at all and a cure rate as high as 99%. The price tag was naturally higher – around $ 100,000.
The debate, whether the pharmaceutical companies are charging astronomical prices using an excuse that it is required for R&D, intensified when Amgen Inc., the Thousand Oaks Biotech giant, won the FDA approval on August 2015, of its cholesterol drug, Repatha and charged around $140,000 for it. The injected drugs improve the liver’s ability to significantly reduce LDL which is tied to increased risk for cardiac arrests and strokes by more than 50%. Even though the drugs are relatively cheaper than the hepatitis C treatments, but the volume of people who have dangerously high levels of cholesterol are more and since the condition is chronic, patients usually need to take the medicine for as long as they live - which makes the pricing questionable.
Such pricing will place a humungous pressure on insures and drive up the premiums for companies and employees.
“This is a much more significant threat to healthcare affordability than the hepatitis C drugs are, and that’s saying a lot,” commented Marcus Thygeson, chief health officer and senior vice president for Blue Shield of California.
On top of this, there is a lack of data that supports the effectiveness of these drugs and their ability to reduce heart attacks.
“The main thing to keep in mind right now is there’s no long-term data. How do we really measure a cardiac drug? Is it going to reduce cardiovascular mortality? Is it going to save lives? The data’s not there yet,” commented Dr. Parveen Garg, a USC cardiologist.
“Is it worth it?” added Garg. “You don’t really know.”
In the debate about specialty drugs’ price to their ability to cure diseases – Gilead Sciences is definitely one of companies that have been scrutinized more, especially after it released its $1,000 pill.
The North California based organization tried to defend the pricing stating that its drugs cure hepatitis C without the side effects of previous treatments.
“Harvoni and Sovaldi offer a cure at a price that reduces hepatitis C treatment costs now and will deliver significant savings to the healthcare system over the long-term. We believe the prices of Harvoni and Sovaldi reflect the value of the medicines,” the company said in a statement.
The abnormally high cost of these ‘specialized medicines’, is putting the insurance companies in the crossfire. Earlier this year, Shima Andre, a woman from West Hollywood sued Anthem Blue Cross for denying to cover the estimated $ 99,000, to treat her hepatitis C with Harvoni.
Anthem explained in the denial letter, that the drug was “not medically necessary” because Andre did not have advanced liver damage.
“I can’t believe that they demand that a person get sicker before they’ll pay for a cure. If there’s a cure for something and you have health insurance, they should cover it,” commented a devastated Andre.
The lawsuit against Anthem Blue Cross is pending in a Los Angeles County Superior Court at present.
David Findley
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