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Drugs for hepatitis C: it's time to slash prices!

The high prices of hepatitis C drugs are an obstacle to treatment for most of the people around the world who are infected by the virus.

When so-called direct-acting antiviral drugs against hepatitis C came onto the market around 2015, some stakeholders hailed them as a means of eradicating this disease. Sofosbuvir (Sovaldi°) was marketed in the United States at the exorbitant price of 1000 dollars per day, reflecting the company's strategy of seeking maximum profits in the richest countries and not eradication of the disease. In part to escape criticism of their prices, Gilead and other companies producing these direct-acting antivirals offered lower prices for the poorest countries or sometimes accepted the manufacture of generics. In some countries, generics are also being marketed without the agreement of the companies concerned.

71 million people around the world were infected with the hepatitis C virus in 2015, and as a result, 400 000 persons died that year. Only 1.5 million people started treatment for hepatitis C in 2016. In middle-income countries (China, Mexico, Turkey, etc.) where about 40% of infected people live, access to the drugs is virtually non-existent due to their unaffordable price.

Against the background of this very unsatisfactory situation, the World Health Organizaion (WHO) applauds the counterexample provided by Egypt, which has adopted a vigorous policy for combating this disease, and where 1.5 million people received treatment between 2014 and 2017. In this country, local generic manufacturers offer antiviral treatments at much lower prices than the discounted prices from Gilead and Bristol-Myers-Squibb.

As was the case with AIDS at the beginning of the 21st century, the best means for most of the world to combat hepatitis C will be through companies which rely on high-volume sales, such as generic manufacturers, including the use of flexibilities in intellectual property rights.

©Prescrire 1 December 2018

"Drugs for hepatitis C: it's time to slash prices!" Prescrire Int 2018; 27 (199): 307. (Pdf, free).

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