New Internationalist

There’s now a cure for hepatitis C… but most can’t afford it

Pills [Related Image]
Dominique Godbout under a Creative Commons Licence

Picture the scenario: a disease is destroying your liver and there’s a chance you will die. There’s a cure but you can’t have it; it costs more than you earn. This cure can be made cheaply, but the company that developed it wants to make a huge profit. There are tens of millions more people like you. Hundreds of thousands of them die every year.

It sounds like some sci-fi dystopia but this is the situation the 150 million people who have the hepatitis C virus (HCV) find themselves in today. HCV is spread through blood-to-blood contact, mostly through shared needles. Around 350,000 people die of HCV-related liver complaints each year but new drugs have been developed within the last 6 months with cure rates higher than 90 per cent. Even though these drugs could be produced generically for as little as $68 for a 12-week course, big pharmaceutical companies such as Gilead are pricing it up to $84,000 – that’s $1,000 a pill.

‘Not only is eradicating HCV within our grasp, it’s something that could be achieved well within in our lifetime,’ says Leigh Daynes, executive director of Doctors of the World (Médecins du Monde) UK, which is campaigning to increase global access to the new HCV drugs. ‘Pharmaceutical companies need to work with us to get these essential, life-saving drugs to those that need them; thousands are dying each week they delay.’

Gilead, which was granted regulatory approval in 2013 for the leading HCV drug Sofosbuvir – brand name Sovaldi – plans to sell the drug for a reduced rate of around $2,000 in middle-income countries, where around three-quarters of the world’s HCV-infected people live. But even then most will still be unable to access the drug. Egypt – which has the world’s highest prevalence of HCV – is one such middle-income country that Gilead announced would be getting discounted treatments.

‘Gilead are only giving a discount to a restricted number of people who access public health centres in Egypt,’ said Chloé Forette, harm reduction and Hepatitis C advocacy officer at the launch of Doctors of the World’s report on access to HCV medicines. ‘For those forced to buy it privately it is likely to be 5 times more expensive.’

To put this in context, the monthly average salary in Egypt is $250.

Gilead may grant what’s known as a ‘voluntary licence’ for some low-income countries, meaning generic producers are given permission to make the drug and distribute it in these countries at a lower price. Most who need the drug globally, however, would remain excluded.

‘This licence is likely to be restricted to 60 countries, which would be the smallest-ever scope for a voluntary licence, excluding around 60 per cent of the people infected worldwide,’ says Chloe Forette. ‘And even in these countries many still won’t be able to afford it as there’s no international funding mechanism available to buy these drugs for people.’

The overarching reason why so many people will be excluded from being cured is not a pretty one. Industry analysts believe the demand for these treatments will translate into annual sales of $9.1 billion for Sovaldi alone by 2017. Those in the pharmaceutical industry often argue that high prices are necessary to pay for the drug’s research and development (R&D) costs. This is not the case for Sovaldi, which is an adaptation of an existing molecule. And even where R&D costs are high, these can be recouped – while also allowing for a healthy profit – from sales in rich countries alone.

Suggested ways to make the treatment affordable through generic competition include patent opposition – where the 25-year long monopolies on drugs are challenged – and compulsory licensing – where pharmaceutical companies are forced to allow others to manufacture the drugs so they can be made and sold for a reasonable price. The World Health Organization has called for a ‘multi-pronged’ approach to tackle the issue, which could include tiered price discounts, voluntary licensing and compulsory licensing.

‘There needs to be a global renegotiation about access to commodities when it comes to global public health threat,’ says Professor Michel Kazatchkine, UN General Secretary Special envoy for HIV and AIDS in Eastern Europe and Central Asia. ‘We have to consider all of the current means we have to bypass the very basic and fundamental contradiction between our international, intellectual property treaties and our treaties on human rights and access to health.’

Many of these battles regarding access to medicines have already been fought, with some success, by those calling for cheaper HIV and AIDS drugs since the 1990s, which is giving HCV activists hope. In 2000, antiretroviral HIV drugs cost $15,000 – meaning only 5 per cent of people in low- and middle-income countries could get them. Thanks to generic competition, 15 years later the same therapy can cost around $60 and more than half of people in these countries can access them.

Activists hope it will not be such a long struggle with HCV, especially as, unlike HIV, these treatments have the potential to cure the disease in a single short course.

‘We have an opportunity to eradicate the virus, so this is a chance to bring the debate back to the international level about our inability to deal with all the major public health issues such as HIV, TB, malaria, and hepatitis C,’ says Professor Kazatchkine. ‘People will continue to die in large numbers unless we completely rethink this fundamental contradiction between human rights and intellectual property.’

Comments on There’s now a cure for hepatitis C… but most can’t afford it

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  1. #2 Margaret Dudley 15 Apr 14

    What if Salk had patented the polio vaccine and charged this exorbitant price. Hepatitis C is a worldwide epidemic and the fact that an effective (90%+) cure has been found requires concerted efforts by all to make sure it is made available in the quickest manner possible. This is a disease that now kills more people than AIDS... over 350,000 people die each year from HCV and/or complications. We now have a CURE for these people! WHY WOULD WE NOT WANT TO CURE THEM? Or should I ask WHY WOULD WE WANT TO CURE ANYONE OF ANY DISEASE? The answer: Because we CAN! A cure is not a bit of good if it never reaches the patient! In fact, I would think you would declare it NOT A CURE AT ALL, if no one can access it.

  2. #3 hatri eluali 22 Apr 14

    we all praying for all the patients all over this small world to have any thing to a cure them of deseas epidemics all types of diserves to make life continous in our planets ,pe0ple home have help the most needs ,all buisness men all the companies all the rich countries ,must know that one day you will need too ,dont playing with lifes of the others ,their freedom ,their diterminations,be mercy with humanbiengs like you ,the power the richness ,not every thing ,the hiest meanings ,the goodwill,the humenbieng value above all this things so help your brothers just one time in your life trep.

  3. #11 deborah smith 20 May 14

    just found out last yr in may i have hcv im 62 so i pray a peson like me on low income will get help mine came through home tatoo in 1980 God please help this happen i know i did this to myself but i was unaware u could get hcv i was so dumb i never heard of hcv it was a boyfriend name and he been long gone now im left with this :}

  4. #15 MONICA SCOTT 30 Jul 14

    I find it disturbing a cure for hep C is found and a price is so expensive most will not be able to afford it. My son was paralyzed age 21,7 yrs ago. Many medical visits, hospital stays and the hep c. It is wrong to put a price on saving a life so another can reap the financial benefits

  5. #16 clive 04 Aug 14

    God gives everyone gifts, some play basketball,some football,etc, also some with the intellectual ability to research and cure. Sir, if this is what u want to do with your gift so be it. There a humans, your people,dying and you're using your gift for financial motivation? There is a reason no one has ever dug up currency, gold andsuch,but never currency. You have that gift for a reason, to test you to see what you do with it. One love, God Bless

  6. #17 Patricia 10 Sep 14

    I have the hcv I wish I could get the meds just think of all theow class people's will die

  7. #18 Renae Moore 01 Oct 14

    In the name of ’JESUS’ find a way to make this available to the people who are in need. Do not be blinded by profits, it is understandable and reasonable to get goooood money for these drugs. However, is inhumane to withhold, simply because of money. With all the ’think tanks’ around, there has to be a way to be profitable and life saving altogether.

    R. Moore

  8. #19 Steve starr 20 Oct 14

    I'm 54 learned I had hcv at 45, doctors put me on a 1 year treatment of interfuron and ribaviron that killed the virus along with my soul,a lot of people refer to interfuron as a wicked drug and I agree infact it's so wicked there's a class action lawsuit filed by Loyd Wright and many others against schering plough the makers of interfuron many people kill themselves most people describe it like there in hell or been through hell I agree strongly sometimes I wish I never heard of interfuron and died just as well. The ugly truth and answer to why they don't make this new drug affordable is the word is over populated and by withholding it from people it is a simple way to cull the heard and make room for the new.

  9. #20 Tracy Gillhespy 12 Nov 14

    It is really scary. We let cancer patients go untreated, we forbid some from getting needed medicine from affordable sources in other countries, and now we let them decide who is worthy of saving. I am speaking about Medicare/Medicaid recipients mostly as well as the uninsured. $1000 per pill? why is this allowed to happen? What have we let happen here? It matters very little how a person gets a disease. People at one point in time said people who got AIDS were sinners and deserved to die. Really? Well I think that if ANTHING is going to be regulated it should be the drug company and the pricing of medicine. The government is manipulating the country's health system as well as the American people to make a profit off of our sickness, fright, suffering and loss. This is clear to see. These people represent us? The insurance companies aren't going to pay either folks, not just govt. funded insurance. A precedent of general consensus about when and who to treat will be established and good luck changing that decision. I have 5 children and 4 grandchildren and my doctor gave me hope after many years of despair that a cure was coming out soon! I was overcome with what I can only describe as disbelief and relief simultaneously. I have been waiting to return to Dr for treatment options only to find out at $1000 per pill, I wont be able to afford to save myself. The most profitable industry in America has shown what the real motivation is here, profit not patients, not cures, and not conscience. I say if a medicine is approved it should then become community property, not of the governmentbut of and for the people!

  10. #21 Anahid 08 Dec 14

    Thanks for raising awareness about this issue. But you said it was spread mostly through sharing needles. You forgot blood transfusions especially before 1992 when the virus was discovered.
    Stigma comes from disinformation.

  11. #24 Angela 25 Jan 15

    Obviously the government doesn't care about curing people who have this deadly virus because if they did they would step up and make sure that this drug is affordable for everyone. This disease is not just transmitted to people who are careless or junkies who are using needles but it is also transmitted thru blood transfusions. Somebody really needs to step up and insure that those who need this drug can get it.

  12. #25 Carrie Johnston 02 Mar 15

    How dare the Drug Companies keep curing medication from the average Joe's. Life saving medications for a pathetic monetary gain. They may not have a price to pay now, but come Judgement day, they won't be allowed to take their riches(money)with them, and they will have no place in the kingdom. They will be judged and found unworthy, they are committing murder to the thousands of people they could help live. It's disgusting and a disgrace.

  13. #27 ch 19 Mar 15

    There's a cure for HepC and it's cheap and airframe and takes 10 minutes of your daily routine.

    It's called kefir. Probiotics are 70-80% of the human immune system. Balance the body's intestinal bacteria will give your body the tools it needs to eradicate hepC infection from your body, naturally and cheaply.

  14. #28 ch 19 Mar 15

    I see that my beneficial comment has been censored.

    And bigoted comments like #26 are allowed to remain. You should be ashamed of yourself.

  15. #29 billy joe 07 May 15

    i have recently learned that i have hcv. but heres the the thing no one can tell me how i got this i have done nothing in my life to even come within 1% a risk of contracting anything and no i must live with this because i worked so hard in life i cant afford the meds due to a accident on a job thats forced me out of work and on our medicad system that hardly appoves anything. so the real question is why must people who have done right in life and by others have to suffer why must anyone suffer when the hole point of life is making good and bad decision and learning from are choices to either live right or wrong by others and your belief system?

  16. #30 mike dee 09 May 15

    It's disturbs me that they are now making a statement that we now have a cure. We already had a cure, just a different medication.

  17. #33 jack 06 Jun 15

    then it is not a damn cure because a cure means for every one who is sick not just rich rock stars we need to put a stop to this kind of crap now the average citizen has been getting it stuck in and broke off for way to long that is plain flat out greed from the people who are doing this we need to stop this money money money crap in our health care industry this is not no cure for hep c it is a real shitty slap in the face for people who have this illness i hope they go bankrupt for there greed i understand business needs to make money but to try and make people believe a pill cost more than most peoples wages is stupid and flat out greedy i hope the people who have hep c that cant afford it sue the hell out these pigs and get it anyway

  18. #35 Breonna dubose 17 Jun 15

    Hello my mom as hepatitis c I found out when I was 13 years old at first I denied it. I couldn't accept the fact that I could lose my mom or wake up and no longer be able to hear her tender voise or see her sweet smile. Every day she would said that she wasn't going anywhere but day by day I see her get sicker and sicker. Its getting so worse that she doesn't eat and when she does she can't hold it down.and when I see her unable to get out of bed it frightens me. I'm only 16 and I scares me and is stressful so much it hard to focus on school that I might flunk cause I'm scared to come home to my mom dead I just wish that the cure for hepatitis c was affordable. I don't want to lose my mom I want my future Children to know there grandmother not hear about her from my life. This is a curse

  19. #36 Bobby Brown 20 Jun 15

    I doubt that there really is a cure for Hepatitits C. The word ’cure’ is a powerful word in medicine and it implies that patients no longer need take medications or treatments and are no longer bothered by the ailment. However, it would not surprise me--and should not surprise anyone else--that any ’cure’ would be incredibly expensive. Western medicine has too much invested in the finance of treating patients to be concerned with curing them in most cases. If, for example, I demonstrated that the cure for cancer was a cinnamon and garlic puree, every hospital in America would forced to close leaving many doctors, nurses, technicians and support staff out on the street.
    The collapse of the health care sector would be disasterous for the rest of our economy as well, easily passing the 2008 financial industry collapse/ bail out and most likely the Great Depression.
    The only way to prevent this is to continue to ’treat’ diseases and if a cure is found it has to be made to be very expensive.

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About the author

Nick Harvey a New Internationalist contributor

Nick Harvey spent 2007 and 2008 hitch-hiking from Europe to Asia, writing along the way, and becoming a leading voice on LGBTI (lesbian, gay, bisexual, transgender, intersex) issues in India. Since then he’s published dozens of articles – mainly for New Internationalist  – on both well-known and obscure international human rights issues from the plight of Tuaregs in Mali to the fight for democracy in Swaziland. As well as freelancing as a journalist, he’s currently the communications lead for the health charity Doctors of the World (Médecins du Monde) UK.

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