Complaints Over Price of Gilead's Hep C Cure

LOS ANGELES—There's good news and bad news about sofosbuvir, the new Gilead Sciences drug that cures hepatitis C, which currently afflicts more than 3 million Americans, and approximately 170 million people globally. "By comparison, about 1.1 million Americans have HIV, which has infected about 34 million people globally," reported NPR in an article published Monday.

The good news is that the drug completely cures hep C, and requires only a few grams to do the job. The bad news is that Gilead is charging $1,000 a pill for sofosbuvir. "A typical course of treatment," noted NPR, "will last 12 weeks and run $84,000, plus the cost of necessary companion drugs. Some patients may need treatment for twice as long."

The article also claims that 90 percent of hep C patients are expected to be completely cured by the drug, assuming, that is, that they know they have the disease and, assuming they do, can afford the drug.

The price tag has a few people fuming, and Michael Weinstein, president of AIDS Healthcare Foundation is one of them. "For Gilead, we have outrage, pure and simple," he said.

Andrew Hill, a researcher in the Department of Pharmacology and Therapeutics at the University of Liverpool, thinks the company is charging too much, considering the cost of production, arguing, "Even when we were very conservative [with our estimate], the cost of a course of these treatments would be on the order of $150 to $250 per person."

Hill used the cost of making similar antiviral drugs for HIV (approximately $1 per gram) to estimate the cost to produce sofosbuvir. "The amazing thing with hep C is you only need a few grams of these drugs to cure the infection," he added. "You need 10 grams or 30 grams of drugs."

Gilead has responded to complaints by arguing that the price is a fair reflection of the investment made to produce the drug, and that the cost will surely come down over time.

"We didn't really say, 'We want to charge $1,000 a pill,'" said Gilead VP Greg Alton. "We're just looking at what we think was a fair price for the value that we're bringing into the health care system and to the patients."

He added, "Those who are bold and go out and innovate like this and take the risk—there needs to be more of a reward on that. Otherwise, it would be very difficult for people to make that investment."

Another researcher, Beth Israel Deaconess Medical Center in Boston, said that the cost may in fact be justified ... for the moment, and pointed to the fact that Gilead did not actually manufacture the drug, noting "that Gilead paid more than $11 billion to acquire a smaller company that developed sofosbuvir," and argued that the company had to be able to recoup that investment.

However, she also added, "You only need about 150,000 people to recover that cost. And so, if you're treating 2 million people, once you have recovered your cost, then I think it's ... I don't want to say it's unfair, but it does start feeling more exploitative."

She suggested that once the investment is recouped, Gilead should cut the price extensively.

"That's very unlikely that we would do that," responded Alton, adding, "I appreciate the thought."

When pressed about the need for cheap hep C cures in Third World countries, however, the Gilead VP admitted the price would have to come way down. "I don't think we'll be able to get it into the low hundreds. But I think we can get it into an affordable range for them. It'll be from the high hundreds to low thousands for these types of markets."