Half a million killed needlessly each year by dread hepatitis C
Don’t let drug companies, lobbyists prevent availability of cheaper drugs
An estimated 70 million to 200 million people worldwide have hepatitis C. The number of people newly infected each year ranges from 1.75 to 11 million. In the United States, 3.5 million people have hepatitis C, which causes 20,000 to 40,000 deaths every year. The shocking news is that hepatitis C is curable. At least six drug companies have developed curative treatments that are available today. Simply stated, drugs that cure hepatitis C can save half a million lives every year, but they are not accessible or affordable.
Hepatitis C is a virus most often transmitted through exposure to contaminated needles or, before 1992, blood transfusions. It causes the death of 350,000 to 500,000 individuals every year from complications such as liver cancer (50,000 to 200,000 cases) and liver cirrhosis (120,000 to 325,000 cases). Is this health care tragedy a “medical genocide?”
Genocide is a combination of a Greek word “genos” (birth/genus/kind/ race) and a Latin word “-cide” (murder/kill/massacre). It refers to acts committed with intent to destroy groups with
particular characteristics (national, ethnic, racial, religious, economic or others). The United Nations Genocide Convention does not recognize “medical genocide,” but history is replete with acts committed with the intent to destroy a group with specific medical conditions (genetic disabilities, medical disabilities, low IQ). In this instance, people with hepatitis C are a large, well-defined group with a deadly disease; cure is available but at exorbitant prices; withholding therapy for economic profiteering is causing the death of half a million of them every year — a medical genocide.
Sofosbuvir is a highly active hepatitis C drug that costs $90,000 to $100,000 for one course of therapy. The drug was approved by the Food and Drug Administration in 2014. After just 27 months on the market, the drug had generated some $36 billion in revenue for its owner, the biopharmaceutical company Gilead, surpassing by far the cost of research and development, which was likely less than $500 million.
In India and some other countries, generic forms of sofosbuvir cost $200 to $500 for a full course of therapy. The cost of production of the drug is low, less than $100. Good profits can be generated from deeper penetration of an affordable treatment rather than from profiteering. In the United States, if Gilead and health-care authorities (aiming to eradicate hepatitis C) agreed to even a high price of $5,000 for a full course of therapy, this would generate immediate profits of $15 billion to Gilead, which could be reinvested in other profitable endeavors.
Gilead would “do good and do well.” The disparity in the price of a course of sofosbuvir among different countries is caused by many factors. The price is highest in the United States, even though the drug was developed here with taxpayers’ money. Our elected representatives state that “no American will die from lack of access to health care,” but more than 20,000 Americans are dying every year from this one disease.
How can we prevent death from hepatitis C? One possibility involves a little-known law that allows the U.S. government to buy a drug at a reasonable cost to address a health-care crisis, such as hepatitis C. The law was used in the 1960s and ’70s to buy several medications at a lower cost. However, the increasing power of the drug industry and its lobbies has prevented similar, more recent attempts.
Another possibility involves what is commonly known as “march-in rights.” This law gives the federal government the right to license a patent itself if the patent owners received federal funding for their research. March-in rights can be exercised when there is a threat to public safety (as hepatitis C clearly is) that the patent owner is not equipped to handle. In this case, pharmaceutical companies pose a threat to the American people by setting high drug prices, preventing the eradication of a curable disease.
What is also shameful is the paralysis of our nation and the world when facing the powerful drug industry and its lobbies, allowing the death of up to half a million people worldwide every year. This is also allowing the persistence of a situation where hepatitis C infects more people than are cured with the drugs every year. By 2015, the number of people treated for hepatitis C was 5.5 million, but only half a million had received the new, curative drugs referred to as “direct-acting antivirals.” Could the drug industry be setting conditions that allow them to secure an indefinite source of profit?
A lesser-discussed aspect of this issue is the responsibility of people who are aware of the situation but remain silent, including American and international health-care regulators and physicians who are entrusted with the lives of hepatitis C patients. We have become passive participants in the ongoing medical genocide of patients with this dread disease perpetrated by a drug industry unwilling to “do good while doing well” and withholding curative treatments for the sake of merciless profiteering.