Making Hepatitis C Treatment Affordable

Between 130-150 million people worldwide live with hepatitis C, a chronic liver inflammation caused by a viral infection. While the condition is extremely common, effective treatment options remain elusive and very expensive. The World Health Organization has just listed hep C treatments as “essential,” warning drug companies that they must adjust their pricing and licensing schedules to make costly treatments available in the Global South. It’s not just the developing world that needs more affordable treatment options, though: Even in Western nations with excellent health care systems, the costs of managing the condition can be devastating.

The good news about hepatitis C is that thanks to the widespread nature of the disease and developments in the medical field, more and more treatment options are becoming available. The bad news is that many of these treatments are extremely costly, a significant barrier to providing treatment in the Global South. Even with reduced prices and compassionate use exemptions provided by pharmaceutical companies, it can be unfeasible for people to complete a course of treatment. While competition is slowly driving drug prices down, “reduced” prices for the medications are still formidable.

It can cost up to $100,000 for a round of treatment for hepatitis C and the process is grueling for patients. Whether patients take painful injectable medications or tablets, they can experience disabling side effects like severe nausea, and some find themselves needing to take a leave of absence from work or school while they complete the treatment, which takes months. To add to the burden of treatment, in some cases the initial round is not successful and patients need to repeat the process all over again. Between the cost, the length of treatment, and the unpleasant process, it’s difficult for patients to adhere to a treatment plan, whether they’re employees of a Fortune 500 company with excellent benefits or residents of an impoverished community in India with limited access to resources.

Pharmaceutical companies justify extremely high prices for innovative medications on the grounds of high research and development costs. They argue that investing in drug exploration is risky a compound may fizzle out at some point in the development process and bringing a drug to market is extremely time and labor intensive. The process involves months to years from discovering new chemical compounds to final FDA approval after multiple rounds of human trials to confirm the medication is safe. These concerns support unique copyright protections extended to pharmaceutical companies that want to protect their formulas from generic replication, ensuring that if doctors and patients want a given compound, they have to purchase it from the pharmaceutical company that owns the copyright no matter how much it costs.

Critics have a different position on the subject. While they don’t dispute the costs of drug development, they also note that drugs with a high price tag contribute immeasurably to profits, and also tend to raise corporate stock when drug companies release expensive and innovative medications, their stock rapidly rises. Wall Street loves new treatment for conditions like hep C almost as much as patients do. Advocates are pushing for a reduction in the prices of essential medications, especially in the face of refusals to pay for them on the part of insurance companies and agencies like Medicaid.

Now that the World Health Organization has formally classified these medications as essential for patients, the result may be reforms in pricing. With the WHO to back them, global governments have more clout when it comes to pressuring drug companies to lower prices or negotiate licensing agreements with firms that work in the Global South to provide drugs at reduced prices. While these drugs will likely remain expensive in the West and Western patients will continue to face the same problems they do now the mandate for lower prices in the Global South could have a very meaningful impact of the lives of millions of people around the world who are fighting hepatitis C with minimal personal and financial resources.

Photo credit: Sam-Cat

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