The new drug for hepatitis C treatment comprises a combination of both Ledipasvir and sofosbuvir which are both novel direct-acting antiviral agents.1These agents possess great potency against the hepatitis C virus.2The high cost of the new hepatitis C can be justified with several reasons. Both Ledipasvir and sofosbuvir may be administered as single tablets which may have or lack ribavirin and are to be taken once per day for a duration of 8, 12, or even 24 weeks.3 A justification for the high price of up to $1000 per pill, and $84,000 for a therapeutic duration of 12 weeks with sofosbuvir alone may also be justified with their ease of administration, shorter treatment duration, and minimal side effects compared to earlier therapies.4
Another justification of the high price for the new drug is the need for a need of return on investment by the manufacturer, Gilead. Gilead bought Pharmasset –which had initially identified the drug– in 2012 for a price of $11 billion.5It can hence be viable to conclude that sofosbuvir was developed for a cost of $11 billion; therefore, the company may have to sell the drug at a high cost to have a return on investment.6
A value driven approach may also justify the high cost of the new Hepatitis C drug. The approach lays emphasis on the comparison between sofosbuvir therapy and other HCV infection treatments.7 For example, a 12 week regimen of a combination of ribavirin, sofosbuvir, and pegylated interferon from Medi-Span has wholesale average price of $116 910.72 which is more expensive compared that of the new drug.8 Value may also be seen when one considers complex analysis of cost-effectiveness, such as the ratio of additional cost to effectiveness which stands for the additional cost of an increment of quality adjusted life year.9 The new expensive sofosbuvir therapies offer a good deal in cost-effectiveness when one considers the minimized side effects, effectiveness, and the reduction in downstream cost due the halted progression of the disease.
Hepatitis C is spread when the blood of an infected person gets its way into the body of a non-infected person.11 The infection can also be transmitted sexually but in rare cases.12 Mothers with the disease can also infect their children at child birth.13 Symptoms of the disease indicate advanced liver disease.14 The symptoms/consequences of infection include: nausea, fatigue, dark urine, jaundice and fever.15
There are several differences between the new and earlier treatments of hepatitis C. One difference is that the new treatment can offer high virologic responses of 93 percent to as high as 99 percent depending on the duration of therapy.16 That is a very great difference compared with earlier alpha interferon therapies which had maximum viral response rates of 50 percent.17 Additionally, while earlier therapies required specialist treatment due to their unsatisfactory nature and side effects, the new drug can be easily administered by general physicians with minimal side effects.18
It is unethical not to treat the disease because the infected people if not treated will continue to pose a threat of infecting those who are not yet infected.19 In spite of the effectiveness of the new drugs for HCV infection, their cost is prohibitive for the prisoners to benefit. Researchers have estimated that the cost of treating all HCV infected prisoners to be $33 billion.20 Unless more affordable drugs are made available for HCV infection treatment, most prisoners will be unable to access treatment.21 This same scenario will also occur in countries that are poor whereby infected people will continue to suffer from the infection due to the high cost of the effective drugs.22
Bibliography
Nejm. 2014. http://www.nejm.org/doi/full/10.1056/NEJMe1401508.
Brennan, Troyen, and William Shrank. 2014. 'New Expensive Treatments For Hepatitis C Infection'. JAMA 312 (6): 593. doi:10.1001/jama.2014.8897. http://jama.jamanetwork.com/article.aspx?articleid=1890401&resultClick=3
Cdc.gov,. 2014. 'CDC DVH - Hepatitis C Information For The Public'. http://www.cdc.gov/hepatitis/C/index.htm.
Prisonlegalnews.org,. 2014. 'Prisoners Unlikely To Benefit From New, Highly Effective Hepatitis C Treatment | Prison Legal News'. https://www.prisonlegalnews.org/news/2014/jul/9/prisoners-unlikely-benefit-new-highly-effective-hepatitis-c-treatment/.
