14 DAY TRIAL // Discovered in 1989, hepatitis C for the longest time remained one of the afflictions that could not be treated with existing drugs. Over the past couple of years, a series of innovations and breakthroughs have led to the development of compounds that can now address hepatitis C infections. However, the world appears incapable of distributing the medication among the poor.
As always, poor and developing countries will bear the brunt of the huge, artificially-inflated costs associated with hep C medication. Gilead Sciences in Foster City, California, last December released its drug sofosbuvir to the market for $1,000 (€720) a pill, which means a total cost of $84,000 (€60,700) for the necessary 12-week course.
Beerse, Belgium-based Janssen Pharmaceuticals released the drug simeprevir at a cost of $66,000 (€47,700) for the entire course. Naturally, almost no one living in a developing or poor country can afford to pay such a fortune for the drugs that might save their lives. The situation now is very similar to the one that developed after the first AIDS medication was synthesized.
When antiretroviral therapies first appeared, they too cost tens of thousands of dollars per years for a single patient. Between the early 1990s and the mid-2000s, overall individual costs for treating AIDS decreased from $10,000 to $100 (€7,200 to €72), partially due to the policies of some states.
Countries such as Brazil and Thailand have recognized the necessity of not letting people die early on, and so their governments have issued so-called compulsory licenses, which allow for the manufacturing of generic versions of brand-name HIV drugs. In essence, these countries have stepped over patent rights in order to save lives, which is something that needs to occur around the world.
It took three decades for AIDS medication prices to drop, but analysts say that a similar thing may occur with HCV drugs as well, provided that the political will and public pressure exist to do so.
“We’ve been here before,” comments the head of the global hepatitis program at the UN World Health Organization (WHO) in Geneva, Stefan Wiktor. He is also the lead author of the first-ever guidelines for treating hepatitis C, released earlier this year. HCV is dangerous because it causes liver cancer and cirrhosis, two extremely dangerous conditions.
“Competition and generic production really are the keys to reductions in prices.” Wiktor adds, drawing another parallel to AIDS medication. Organizations such as the Global Fund to Fight AIDS, Tuberculosis and Malaria played an important role in funding companies that synthesize generic versions of the drugs used to fight HIV, Nature News reports.
Statistically, Egypt features one of the world's most HCV-infected populations, with nearly one quarter of all its people carrying the virus. The country has an annual healthcare budget of $4.5 billion (€3.25 billion), but this sum is entirely and utterly insufficient to cover the price tags of modern drugs for even a small portion of its infected population.
According to an analysis recently published in the February issue of the journal Clinical Infectious Diseases, it is entirely possible to produce generic versions of expensive HCV medication at a cost of $100 to $250 (€72 to €180) per 12-week course. However, the manufacturing of these drugs will not commence until a large demand exists, and patent legislation is making this impossible in many areas.
Interestingly, the situation is likely to get particularly dire for developing countries. While their poorer counterparts will benefit from generic licensing deals, emerging markets will likely be seen as easy pickings by large pharmaceutical corporations. The only method of ensuring this does not happen is for national governments to consider compulsory licensing.
The UN World Trade Organization (WTO) usually opposes such practices, but it is likely to sanction them in this case because affordable medicine prices are seen as a way to protect public health. Fortunately, for the UN, human life is still more precious than corporate profits.