emo Do you trust Resof-L by Dr Reddy's ?

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6 years 6 months ago #8460

Thus I agree that 750 USD for 12 weeks is possible

What I do know is that an Indian can buy generic Harvoni for $4 a pill or $336 for a 12 week tx

At this moment in time you are both wrong. Sorry, but there is no way to sugar coat that.

In the future it will be possible, but right now you would need to be willing to fund (in advance and at a cost of over $1 million USD) an entire production run to get close to this price. You would probably not be getting it from India either due to the 7% royalty paid to Gilead.

Currently in India any price below $1000 USD should be viewed as being too good to be true.

Here is a link to what preports to be community pricing:

testandtreathepatitisc.files.wordpress.c...-sof_ldv-summary.pdf

And here is some expert commentary about it.
Hi James,

There are many things wrong in this sheet
  1. First people need to understand Hetero is the only manufacturer and Cipla , Natco and rest all just package it and sell. If you see Hepcivir L Box, it clearly says manufactured by Hetero. So why would Hetero price be higher than Cipla(in your sheet). Cipla and Dr. Reddy’s are premium brand in India over all the others ones in the sheet. Yet they have the lowest prices.
  2. The absolutely nothing called community pricing. We asked head of sales for Cipla and he confirmed that the only discount that is given is to govt agencies who source meds for BPL(Below Poverty Line) card holders. The packing and barcoding everything reflects that and not a single pill can be distributed outside the authorized BPL channel. These batches are handled directly by manufacturers and not even distributors have access let alone pharmacies.
  3. Community pricing seems like a scam to sell meds at ridiculous prices.

I am worried, with these practices of selling Schedule H meds without prescription etc something really bad will happen and DCGI will clamp down the whole process.

Here is Dr Andrew Hill's expert commentary on it.

www.ncbi.nlm.nih.gov/pmc/articles/PMC4403972/

Note that he is not talking current market, but future possibility and gets to an API cost of $193 USD for Harvoni. If this statement was true:

What I do know is that an Indian can buy generic Harvoni for $4 a pill or $336 for a 12 week tx.

Then the current API costs would need to have been at Dr Hill's future forecast price point 2 months ago when the APIs were ordered, prior to manufacture, distribution and sale. Of the final $336 price 57.5% would be API, 7% would be for Gilead and 35.5% ($119 USD) would be all that was available for freight, testing, manufacture, packaging, distribution and reseller margins.

Really?

The only people who could meet these unrealistic price expectations will not be selling valid product.

By suggesting these prices are realistic you are doing three things:

  • Creating unrealistic patient expectations
  • Making it easy for purveyors of fake product
  • Making it hard for people providing the real thing as their prices appear too high

Lower prices will come, but at the moment circa $1000 USD is as good as it gets for generic Harvoni and this is only for delivery in India or Bangladesh, not delivered to your door.


YMMV
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6 years 6 months ago #8472

timesofindia.indiatimes.com/india/Desi-g...cleshow/50609836.cms


"The research paper noted that between January 1 and October 2015, the price of the APIs for sofobuvir fell from $8,754/kg to just $2501/kg. Over the same period the price of daclatasvir fell by $1,664/kg. To the cost of API needed for a 12-week treatment course, the researchers added cost estimates for formulation and packaging and a mark-up of 50% to arrive at the price of $200 for the 12-week regimen."

Last Edit: 6 years 6 months ago by Alsdad. Reason: added info
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6 years 6 months ago #8478

I stand unashamed....
but corrected.
This is the first time in my life I have been wrong......
Keep up the good work Doc!
Mike


This email address is being protected from spambots. You need JavaScript enabled to view it.
forums.delphiforums.com/generichcvtx

G 1a F-1
Started tx 10/23/15 (Meso sof & led) ALT 48 AST 28 v/l 1.6 mil
11/17/15 4 wk lab ALT 17 AST 16 <15
11/18/15 Started Harvoni
12/16/15 8 wk lab ALT: 15 AST: 13 V/l UND
1/14/16 Fin. Tx
7/07/16 UND SVR 24

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6 years 6 months ago #8480

I have since bought one of the recommended brands here. But if what Dr James say is true, what about the quote they actually gave me?

I am too very skeptical of the pricing no doubt, and with your research it proves that the current pricing hasn't fallen so low. Since you have also mentioned that Dr Reddy is a big brand in India, they wouldn't be going out of their way to scam potential customers now would they?

As I have said time and again, the price is in the actual email they quoted me. It's the generic version of Harvoni, not Sovaldi.

What I can guess from here is that, Drreddy might be under prcing their products and they are spoiling the market. Since that's the price they quote me, they can quote anyone that price too, including local Indian, not just overseas order. Which is why in the brand thread, I have requested for help to ask them for their pricing (no one responded as of now).

In terms of calling it a fake, that's the whole point of me starting this thread, is plausible, at 50/50. Again, some expert already mentioned, it's a big brand. If their price is good, and if we could somehow get a sample to be tested by your lab, then we can finally agree if this is indeed a scam or not.

Last Edit: 6 years 6 months ago by dtdwfhpc.

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6 years 6 months ago #8481

Hello Alsdad,

This article timesofindia.indiatimes.com/india/Desi-g...cleshow/50609836.cms

Is reporting the study from Dr Andrew Hill I linked to. There are several things to observe:

  • Andrew's numbers are based on customs declarations which, as many of us will be aware, may not reflect the true value of the product shipped because under declaring the value reduces the taxes payable
  • Unlike Andrew who observes, we operate in the market and know what prices are available. API prices have been falling, but are still a long way north of what Andrew suggests and at the bottom end of the market there are quality issues. I'm aware of major manufacturers that paid 3 x the suggested Sofosbuvir price to produce their well known generic Harvoni.
  • Andrew is talking about Sof+Dac. The per kilo prices for both are currently very similar, but you need 33.6 g of Sof and only 5.6 g of Dac so 86% of the API cost is Sof. Ledipasvir costs nearly 5 x as much per kg as Sof and you need 8.1 g so it costs about 120% as much as the Sof. In other words the API cost for Sof+Led is almost exactly double that of Sof+Dac


In this part of the article:

According to a recent WHO survey on Hepatitis C treatment, the combination is being sold in India for about Rs 46,500 or about $700 per patient for a three month regimen.

This reference is almost certainly referring to this article:

www.wpro.who.int/hepatitis/resource/feat...idasiamissingout.pdf

So the $700 figure refers to Sofosbuvir+Ribavirin, not generic Harvoni.

Given that Daclatasvir is only just becoming available via Natco and generic Harvoni has been on the market for less than a month it seems a little implausible that WHO statisticians put together and published a survey over Christmas.

Supply chain integrity has always been a key part of this site and like Greg Jefferys

blogs.hepmag.com/gregjefferys/2016/01/he...s_c_treatmen_21.html

I would reiterate that anyone purchasing generic Harvoni for under $1000 in India would do well to have access to HPLC, Mass Spec and NMR equipment.

Over the course of this year I have little doubt we will see generic Harvoni prices fall below $1000 USD, but right now it is unrealistic.

I expect prices will fall in Bangladesh first.

If anyone reading this sources generic Harvoni in India for $700 USD send me one tablet from each bottle. I will send you a box of 6 Twinvir to replace them and publish the results here. I suspect those 6 tablets will do you more good that what you purchased.


YMMV

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6 years 6 months ago #8482

Dr Reddy's and Cipla are the premium brands in India, but according to what I'm told the product is all being made by Hetero.

Anyway be that as it may, you, as a consumer are not picking 3 bottles off the production line.

Your product has passed through at least 2 hands - a distributor, and the person you got it from.

This is part of the supply chain. I have no doubt all the big Indian manufacturers will turn out valid product.

What you buy is some bottles with their name on them, but what you need is Sof+Led and unless you are standing at the end of the conveyor belt in the factory you need absolute trust in that supply chain that delivered it to you.

As a side note, there are plenty of fake Rolex watches, but very few fake Citizen watches. Premium brands are the natural target.


YMMV
Last Edit: 6 years 6 months ago by DrJames.
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6 years 6 months ago #8483

Thanks for your reply Doc. A few points to address:

It's pure speculation to suggest that large business corps are undervaluing their import costs. Individuals and small operations do it, as you pointed out, to cut the duty paid. It's not such an issue for big corporations because they can offset those duties, and nor is it easy for them to do it even if they wanted to without some very creative accounting.

Your market position is currently the purchase of enough Dac to treat maybe a couple of thousand patients so far? And not all treated at the same time from one bulk purchase, so a kilo-or-two at a time? Big operations will be buying by the drum, and will probably be getting a current price that's tied into a contract to purchase a helluva lot more.

Dac might be new in India, but it's generic APis have been around a lot longer than that, and the price of the generic has been dictated by the world market

Are the major manufacturers still willingly paying those high prices in the face of cheaper products in the burgeoning DAA generics market?

Based on the figures in the article I linked, your calculations put the price of generic Harvoni at about US$4.50 a pill.(or less than US$400 for a twelve week treatment.

Last Edit: 6 years 6 months ago by Alsdad.

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6 years 6 months ago #8484

Surely,the point of the thread is if you get an offer for these drugs at less then 1k based on the
evidence we have thus far would suggest they could be fake.

Who wants to take the risk when you can get access to treatment for as low as 1k US!

As it stands we can't say for sure you can buy for less then 1k per and assure you its what you're paying for
supply chain integrity is worth the extra money.

We're now getting into the semantics of how large corporations buy bulk APIS is it not possible
they had bought APIS befor they had decreased in price.


Sob/Dac from Oct 29 2015
Geno 1b
Fiberscan 9.9 Pre treatment
Fiberscan 7.4 week 10
VL 1.3 million pre treatment
Week 2.5 VL 96
Week 5.5 VL 17
Week 10 VL UD
SVR 3 UD
SVR 16 UD
Cured:
All liver functions in normal ranges.
Last Edit: 6 years 6 months ago by Sirchinenge.
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6 years 6 months ago #8485

Ok. Here we are again, debating about something we have no real idea if this or that.

I don't want to be the guy that try to defend someone that I don't know. But I can tell you, if this can be gotten at this price and they are legit, then we can save even more lives. My family is at the OK range in terms of finance, but I can tell you over in Malaysia, not many people can afford 1k USD.

According to statistics, Malaysia has over 400k Hep C patients, and that isnt' even up to date as I tried digging into the news. It's dated at 2009. So my guess is as what you can think of, it could be in the millions today. Way more than Australia.

Last Edit: 4 years 6 months ago by dtdwfhpc.
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6 years 6 months ago #8486

DTD we don't know it can be bought at the price you suggest the evidence we have thus far
suggests its not the case.

I don't see much point in trying to figure out how much a large business
has paid for a product never mind the figures quoted don't take into account
the actual cost of a business like labor/factories/managers/marketing to name a few.

Sure, 300 is a lot in your country every country has issues with pricing, what do you want
we promote something we can't verify what happens if someone dies.

I'm not defending the prices being quoted I think they will come down.


Sob/Dac from Oct 29 2015
Geno 1b
Fiberscan 9.9 Pre treatment
Fiberscan 7.4 week 10
VL 1.3 million pre treatment
Week 2.5 VL 96
Week 5.5 VL 17
Week 10 VL UD
SVR 3 UD
SVR 16 UD
Cured:
All liver functions in normal ranges.
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6 years 6 months ago #8487

Sir, I agree with you that a couple of hundred US Dollars is no great shakes to most of us on this forum.But, as has been pointed out by DTD (I wish you could change your user nams :lol: ), It's a huge amount of money to many people in developing countries. It's probably the difference between being able to scrape, beg and borrow enough money together to treat, and not being able toafford to treat for many people in such countries.

Isn't the core purpose of this forum to help people obtain affordable generic meds from reliable, trusted sources? That, again as DTD has pointed out, is what this particular discussion is supposed to be about: can anyone verify this source? I don't buy the reasons being given as to why it shouldn't be trusted. Or does everything have to go directly through the Buyers Club and Monkmed from now on?

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6 years 6 months ago #8488

If I am rich, like most of the people here that are from the 1st worlds, I wouldn't be posting this thread.[/quote]

MAN, you got it twisted. You think most from the USA are rich? Your clueless. Especially people with hep c from the USA. I would gather most were from IV drug use (like myself) which puts most in the poor house for most of there lives. USA doesn't equal a fat bank account. More opportunities but you work for yours.


Genotype 1A
ALT 473
AST 226
Virus Load 3,119,030
Results as of May-2016
5 week viral load/undetected as of 12/02/2016
Liver Biopsy Results from Feb 2013
Portal/Periportal chronic inflammation and mild interface hepatitis (Grade 2)
Focal Lobular chronic inflammation (Grade 1)
Portal/Periportal fibrosis (stage 1-2 trichrome and reticulin stains utilized)
Negative Iron stains.
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6 years 6 months ago #8489

He might mean "rich" in the relative sense, as in a 25K almost poverty level income in US might seem rich to somebody doing manual labor in Malaysia. Nonetheless, that doesn't change the fact that about 99% of us are getting screwed over these days by the 1% that own too much of everything and own our politicians.


GT 2b; since 80's, no prior tx, sofosbuvir and daclatasvir compounded from API's at Kingswood Pharmacy in Sydney, started tx nov 6,2015, undetected at 4 wks, UND at 8 weeks, UND at 1 week after EOT, UND at 4 weeks after EOT and UND at 8 weeks after EOT. " I feel GOOD!! I knew that I WOULD!"
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6 years 6 months ago #8505

Al, I have no clue why you think anyone has to go through The Buyers Club or is being
forced to use Monk Med there are choices.

Monk Med simply does the paperwork for James as the scale he is running means he has to have
someone in place to send out the shipments from India they are doing a stellar job so far.

The forum was never set up to allow mass sales by anyone whom came along its
original function was a place we could chat and ask questions as it grew we had vendors come
in and try and sell we decided to allow them access you seem to be confusing Fix Hep C
with your own feelings on this subject suggesting we're not living up to some ideal you have.

James agreed to third partly sales as he did not want to restrict access I don't know any business
that would agree too this yet James has,I don't think you understand the liability we take on
by allowing access ,yet we still do it.

When its clearly explained why the pricing may not be possible you argue that point too.

Its James website, he does not have to provide access or argue about long term Hep C pricing
nor does he have to justify too you or us why as it happens he usually tries to explain rationally
why something might be the way it is, it seems its not enough.

You could set up your own website and invest your own money therefore allowing sales
from anyone you want you could also shut down any discussion you don't agree with!

All opinions are my own and do not represent James or Fix Hep C.


Sob/Dac from Oct 29 2015
Geno 1b
Fiberscan 9.9 Pre treatment
Fiberscan 7.4 week 10
VL 1.3 million pre treatment
Week 2.5 VL 96
Week 5.5 VL 17
Week 10 VL UD
SVR 3 UD
SVR 16 UD
Cured:
All liver functions in normal ranges.
Last Edit: 6 years 6 months ago by Sirchinenge.
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6 years 6 months ago #8515

Sir, your post is so far offtopic, it might as well have been made as a new thread starter.

In your zeal to to 'go off on one' and create a withering put-down, you make points that have absolutely no relevance to the debates taking place on this thread.

Pathetic. I'm out.

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