Is Gilead’s $1000 Pill Worth It?

The Department of Veterans Affairs and other California panels’ solution to the new and extremely costly hepatitis (Hep) C drugs (Sovaldi and Olysio) is to reserve them for the patients with advanced liver diseases, including those awaiting transplants.

What should the patients of “milder” cases do then? Twiddle their thumbs and wait for drugs in development? That’s what the VA suggested. The controversial aspect to the recommendation is obvious, especially since the Hep C virus can linger in your body for years without you even knowing you have it and then you are instantly one of those advanced patients, or one of the 17,000 waiting for a liver transplant.

The other controversial aspect is that the cost per patient can run from $70,000 to $170,000, and there may be too few specialists to handle a sudden influx of patients, according to the report from the California Technology Assessment Forum. An estimated 3 million Americans have hepatitis C.

Addressing the deadly liver virus infects three to five time as many people than HIV, making Hep C a much bigger health threat than HIV.

Sovaldi costs $1,000 a pill for 12 weeks; if you don’t need to repeat it, the treatment runs to $84,000.

In the past, the drugs available to treat the disease came with nearly unbearable side effects that caused many patients to suspend treatment.

Gilead Sciences is involved in the controversy over whether the price is justified. Does the $84,000 price tag represent a fair profit? Gilead says they estimated the cost of producing it, by comparing it to other anti-viral drugs used to treat HIV.

Unlike HIV, however, the new Hep C drug eliminates the virus completely. You are cured.? That kind of definitive outcome may well make it worth the price, says Dr. Camilla Graham of Beth Israel Deaconess Medical Center in Boston.

“Maybe we decide that $100,000 is a worthwhile investment to cure someone of an otherwise devastating chronic infection,” Graham says. After all, it can now cost up to $300,000 to treat patients with advanced hepatitis C, using less effective and more harrowing regimens.