TOPIC:

This a.hole had it all in his hands. And now listen to him. I almost wish I'd never viewed that video as I am now feeling like ripping his head off. But that's not we do in the civilized world, and looking at what happens in some other places I guess I should be thankful for that. Still, for bald faced shamelessness I can only think of one other to rival him and that is Alan Greenspan, previously of the Federal Reserve.

dt

A couple points ... first, this guy wasn't "the inventor," he was ...

Sr. Vice President of Chemistry at Pharmasset, Inc. He joined Pharmasset in 2005 and had responsibility for research strategy, medicinal chemistry, process research, computational chemistry and analytical chemistry functions and was a clinical development project leader. He is an inventor of Sovaldi (sofosbuvir), a treatment of hepatitis C infection currently approved and marketed by Gilead Sciences, Inc.

www.oncorebiopharma.com/leadershipteam/

Why he's given some co-inventor status is a mystery because it looks like he came on board after the drug was developed, but before the trials were completed.

If you're looking for a person to call "THE inventor" it would be Raymond Schinazi who had left the company before the sale to Gilead
en.wikipedia.org/wiki/Raymond_F._Schinazi

... or possibly Jeremy Clark, who actually created the molecule ...

In 2002, a young chemist at Pharmasset, called Jeremy Clark, came up with a compound, called PSI-6130, that would bind, very unusually, with the hepatitis C virus in two places at once. Despite PSI-6130 having been licensed to Roche the following year, the much larger company failed to derive a working drug from the molecule, which, several years later, under Schinazi’s guidance at Pharmasset, turned out to be PSI-7977.

www.ft.com/cms/s/2/542ad524-8b77-11e2-b1...0.html#axzz3lD22Lvzo

Other interesting tidbits.
www.reuters.com/article/2011/11/22/us-ph...#YejzQoYggQXmdVWq.97

In any case, I think aiming any anger at those from Pharmasset is misguided. The evil is at Gilead.

None of Schinazi's companies had any expertise in production, distribution or marketing. Their only expertise was in development. They had no ability talent wise or financially to take the drugs to market and did what any development company does ... sell the drug to a marketing company.

Sofosbuvir cost almost exactly $375 million to develop including exit from Phase 3 trials.

This is clearly documented, via a bit of forensic accounting, on our blog:

fixhepc.com/blog/item/25-the-real-develo...t-of-sofosbuvir.html

Thanks for correcting my error on Sofia's role klhilde, appreciate it.

And you are spot-on, Gilead knew who to run with for marketing. Reading certain online forums...its all about Harvoni, with the Bangladeshi version seen as inferior. Let alone suggesting those suspect Chinese API's....and honestly I thought the same way until I found this site and had a swift re-education lol

Another thing we need to keep in mind before we start pointing fingers at the scientists and project leaders who invent these drugs is that you can't just knock them up in your backyard shed. You need some rather expensive equipment and labs. These are only likely to be available through either entrepreneural development companies such as Pharmasett who then on sell the results/business or the big drug manufacturers themselves. As an employee of either or even as a founder of the development company you are going to have limited, if any, input into the commercial sales side of these drugs.

So what should you do? Get on your high horse and ride out of town? Find a job that doesn't involve inventing new wonder drugs that big Pharma can exploit for excessive profits?

Or do you keep trying to invent/develop drugs that will help mankind even with the knowledge that at least some will be exploited by big Pharma? And maybe, when you are able, to add your own voice of disapproval to what companies such as Gilead are doing. As Sofia appears to be doing now that his career is not beholden to said company. (Mind you, I suspect his comments will have hurt his career prospects within parts of the pharmaceutical industry.)

G

PS: OTOH I consider people like Gilead V.P. Paul Carter fair game!

If you are looking for justification for any of the players in this saga then it can always be found.

I was speaking to a shareholder of Gilead the other day. He felt that he was doing the right thing to buy into Gilead, on the basis that pharmaceutical companies need investment to continue developing life-saving drugs for humanity.

There are many shades of grey in this tapestry.

dt

Meanwhile, there is no sign that hepC will be eradicated from the planet any time soon. And it could have been. It was within grasp. Think about that.

So if we are going to have a blame game at all, who are we going to blame? All the players? None of them? Selected ones that cross our personal red lines?

dt

OK, I'm not finished with this subject, because a recital of "Gilead is Evil" does not satisfy me, not nearly.

There have been monumental disasters in history before. In the aftermath, the questions about who is to blame and who should be punished for it, have always come up.

Take the 2008 financial crash for one example. I have watched documentary after documentary about this. While it is fairly clear what happened and why it happened, for some reason it is not at all transparent who is to be held responsible. I have heard testimony by some of the major players, none of whom considered themselves to have done anything wrong. So far, history seems to agree with them. To date, hardly anybody has been prosecuted, let alone convicted, for perpetrating this disaster which brought the economy of the world to its knees and caused untold suffering to many.

Contrast this with the aftermath of WW2. On that occasion, all of the perpetrators that could be identified were hunted down for the rest of their lives and the lives of the hunters and the harmed. The ones that were found and judged to be guilty of war crimes, which included the slaughter of millions of innocents, they went down for it. The age old excuses ie.
- I was just following orders.
- I only did what I had to do in the context of the situation.
- I was just a small cog in a large machine. I had no control over it.
These reasons did not wash with the war crimes tribunals and the courts.

So the question right here and now is:
How are we at fixhepc going to judge this monumental failure to eradicate hepC, which is the very raison d'etre of fixhepc in the first place? Is this just a place where people tow the party line, ie. Gilead is evil, end of!
Or can we have something approaching a rational ethical debate?

I mean, here we stand in the middle of what I would take for a sci-fi movie if I didn't know it was real. The World being held to ransom by one company who rations out the life-saving drugs that are needed for 150 million people, ensuring a perpetual plague, - c'mon, how likely is that?

So is it the fault of Gilead's CEO?
Then how do you square it that he could not do what he is doing without agreement and collusion from his high command?
Where do you draw the line?
Do you stop with Gilead's high command, and exonerate everybody else?

Well, this is what they actually did after ww2. They joined up the dots all the way down to the people who designed and built the ovens and must have had some idea as to their intended use. They went for them. Was that blame misplaced? You decide. After 2008 they did nothing of the kind. Nobody caused 2008 apparently, it just kinda happened. A select few got filthy rich. That just kinda happened too. All legal.

So what I'm getting to is this. I guess it is up to us to decide what kind of court we are running here and where we want to draw the line. Is it not incumbent on us to do a little better than "Gilead is Evil" for the millions of people without a voice who will continue to suffer and die from hepC because of this monumental debacle? Maybe there should be a "Name & Shame" list set up, maybe not here but someplace. Maybe there should be historical documentation done by somebody about how on God's green earth we all let this mess happen? And how it might be prevented again in the future - probably futile but we have to try, don't we?

And finally an acknowledgement of the work done by Greg and the Doc and the few others who have had the courage to make a stand, the bright stars in a murky sky.

dt

Do in time
You are making too many quantum leaps here to answer one by one.
It is true Gilead has no obligation to lower its price.Corporations Law requires a company to maximise it's profit in the interests of its shareholders.Its not just Gilead.I have seen how agricultural chemicals banned in the first world are actively promoted in the third world.I have seen stacks of new asbestos roof sheeting in warehouses all across south east asia.Asbestos kindly supplied by Canada,with the excuse that if they don't ,it will get sourced from Kazakhastan,so we might as well get the money.I have seen children playing in the dust of broken sheets,The promotion of sugar products,and the subsequent diabetes 2 epidemic far overshadows Hep C.The list goes on and on.And don't even start on tobacco.
Corporations are as ruthless with each other as they are to their clients.It is a ruthless,merciless system that hides behind such meaningless epithets such as “Freedom,human rights,democracy”,and bomb into oblivion anyone that gets in the way.
Kindness,generosity,decency,have no place in their world.What they are doing cannot be considered a “war crime” because there is no defined war as such The rare Jonas Salk's of the past are looked on as foolish abberants.And therein lies the problem.It is an human ethical problem for which there are not and can never be any laws.
As human beings we have an obligation to be nice to each other.It is incumbent on the ultimate survival of the human species.But no law can ever enforce this.If a car driver comes across a crashed cyclist bleeding to death on the side of a lonely road and says yes I will help you,but first sign over all your worldly belongings to me,he is probably not breaking any law,but if found out,would have to endure the derision and scorn of all decent people.Look what happened to that idiot dentist that shot the Lion in Zimbabwe.
And that really is the answer with Gilead.Hold it up to scorn and derision.Throw every kind of abuse possible at its lack of ethics.Support countries that say that when it comes to a life saving drug,stick your patent up your “fat corporate asses”Do what Greg and Dr Freeman,and all the others are doing and find ways of circumventing the process.It is the only real weapon.
Use any means legal or otherwise of breaching their defenses.
My real hope is that someone will come up with a biosimilar,which will really send them screaming in agony.I believe some European group is already searching 3000 existing molecules to find an effective replacement for sovaldi.

Hi dointime,

For my part I have no wish to participate in any self appointed "court" that sits in judgement on big Pharmco or others that you mention. I suspect that history will judge them appropriately.
I do not believe that Gilead or any of its staff are necessarily "evil". Greedy, unethical or misguided? Yes!
I do believe that it is appropriate for people to point out unconscionable conduct such as the statement by Paul Carter in the second paragraph of the OPs link.
I will take the time to post what you call "justification" and I call "explaining broader context" when I see people passing judgements on the basis of guilt by association.

I do however agree with your final sentence.

G

miko3

I like and agree with just about everything you have written here. Good post.

I didn't say that Gilead was committing a war crime, just that the suffering caused is at least on the scale of a war crime, and needs to be looked at with just as much consideration. That suffering is intentional and malicious. It is the holding to ransom, governments round the world, using the lives of their citizens. The face of war has changed since ww2, but maybe this would not be classified as war, just a symptom of a "ruthless, merciless" system, or maybe it is all just semantics.

"And that really is the answer with Gilead.Hold it up to scorn and derision."
I agree, except that I would cast my net wider than Gilead and I am not repenting about this. But in the grand scheme of things it is a small difference that we have.

Anyway, given the deplorable state of affairs as you describe it, and the failure of our democratic institutions to address it, I think you are right about this:
"Do what Greg and Dr Freeman,and all the others are doing and find ways of circumventing the process.It is the only real weapon."

I saw this morning a post by Greg who has come up with yet another solution and can now ship generic Harvoni. It made me smile. Keep chipping away at the Wall and eventually the flood can't be stopped.

dt

Well, I guess its my turn to weigh in. Gilead is like a really spoiled kid who can get away with anything. It seems the parents feel any discipline might inhibit little Gilly's potential, so no spankings or priviledges lost. He can do as he pleases.
The free market system should not apply to life saving drugs, just as it doesn't in times of emergency- like after a hurricane. After such a disaster, it is unlawful to jack the price up on essential goods. If merchants do, they faced hefty fines or worse.
The government made that the law of the land-no price gouging when lives are at stake in times of emergency.

The government needs to tell little Gilly enough of this crap.
Don't hold your breath. They like Gilly's money more than our lives.
Plus, we are "damaged" goods.
If Gilly hit a home run for breast cancer and tried this, I really believe those fools in Washington would do something-not to save the women, but to get more votes.
Sad.
Mike

Thanks Mike,

What I've been trying to say all along is that if blame is going to be apportioned then it needs to land at more doors than just Gilead's. One of those doors would be the democratic institutions, aka the government. If the government chooses not to carry out its duty to protect the vulnerable from the strong, if it chooses not to seriously do its duty in tackling the public health epidemic of hepC, then it is not fit for purpose. I think that needs to be said out loud. What is the point of having a democracy at all which demonstrably is not doing these things.

I wonder how much was spent on sending aid to Africa to tackle the ebola epidemic? I'm not saying that that shouldn't have been done, but why couldn't it also be done for their own citizens? Treatment tents set up on every corner. Sleeves rolled up. All hands to the pumps. Not glamorous though, is it? I think you nailed it. What gets/loses the most votes?

dt

dt

Well, I guess it's now my turn to weigh-in,

Dear dt, miko3, gaj, mgalbrai (sorry if I am missing anyone),

I totally agree with your sentiments. But while the scale of what is happening with hepatitis C is global, I think it is a mistake to make a comparison with the financial crisis of 2009 or even WW2 war crimes.

The main problem with hepatitis C today is the price of treatment set by Gilead, coupled with the fact that they have managed to secure a near-global monopoly through crafty licensing deals and market segmentation. They were not "following orders", they were not "forced to do it by the market". It was their own ethical and business decision.

However Gilead might have arrived at this position, we all think the consequences are evil. We are not prepared to be patients who will wait patiently in line... We are out-raged and we have no patience!

But if we are to be taken seriously by our governments and their decision-makers we have to turn that anger into hard facts from reliable and citable sources:

* How much, exactly, is the mark-up on cost of production to sales price?
* How much money, exactly, do the Gilead board members make each year?
* What is the rate of return, exactly, on each Gilead share per year?
* How much of Gilead's turn-over, exactly, goes into R&D?
* How much of Gilead's turn-over, exactly, goes into legal costs?
* How much of Gilead's turn-over, exactly, goes into marketising and advertising?
* How much of Gilead's turn-over, exactly, goes into government lobbying?
* How much of Gilead's turn-over, exactly, goes to taxation?

* How many people die each year because their government could not afford to treat them?
* How many more people could be treated if the cost was halved?
* What would academic experts consider to be a fair price for treatment?

* How many on-line Hepatitis C support groups are funded by Gilead?
* How many on-line Hepatitis C support groups funded by Gilead censor posts about generics?

* How many people with F3/F4 are treated each year by government-funded health programs?
* How many people with F0-F2 are not treated by government-funded health programs?
* How many people are being "ware-housed" until the price falls?

* How many people are actually treated through one of Gilead's aid programs?

...
... No doubt many more questions like this can and should be asked.
...

Obviously, a lot of people came to fixHepC firstly to get a treatment. But it now seems equally clear that many of those same people are staying on fixHepC to try to help others.

I don't want to attack or blame anyone. But I personally believe that trying to get answers to the above questions is a legitimate way to really help others get the treatment that they deserve.

Today everyone expects that fair treatment in law is a basic human right. We have to get to the point where everyone expects that medical treatment for a fair price is also a basic human right.

Yours,

Vororo.

Good points V,
Sounds like a great topic for a doctoral thesis!

Bottom line:The people who really set policy-the 1% who have all the money- like this model: if the rich get richer, they will hire more poor people, so don't excessively tax or regulate big business. Gilead chooses to register its company abroad to avoid paying its fair share of taxes.
The Koch brothers and their ilk run this country.
If one of them had HCV, they could afford treatment costs using spare change.
Mike