TOPIC: How Big Pharma Pressures States to Pay for Pricey Pills

From Bloomberg:

Nothing about a Washington state lawsuit called B.E. v. Teeter is as simple as it seems.

It was filed this year by two hepatitis C patients against the state’s Medicaid program to help the poor gain access to drugs such as Gilead Sciences Inc.’s $1,000-a-pill cure.

But behind the team bringing the case is Gilead itself. While the drug giant isn’t involved in the lawsuit, the company and its foundation have donated hundreds of thousands of dollars to the researchers, lawyers, patient advocates and medical expert who have helped build the case.

Gilead said its donations have nothing to do with the legal fight. If the plaintiffs prevail, however, Gilead and other drug companies stand to make billions because Washington’s Medicaid program would be forced to cover expensive treatments -- and other states may be pressured to follow suit.

www.bloomberg.com/news/articles/2016-09-...o-cover-pricey-pills

didn't happen to donate the pills as well, did they?

J.

This doesn't surprise me a bit. People (like me) in the US are howling about their insurers not covering these outlandishly expensive drugs when they should be complaining about the manufacturer charging these ridiculous prices.
If insurers (both private & government) are forced to pay Gilead's ransom, the cost will be passed right to their clients the next fiscal year in the form of premiums & taxes.
In the end, it only seems logical that the government pay Gilead the big bucks since the same government paid to research and develop its flagship product, sofosbuvir.
What a mess.
Thank God and James Freeman for generics.
m

mgalbrai wrote:
Similar things I noticed also in RO. I've heard many patient's complaints and also read a lot of "honest" articles where HCV advocacy groups are targeting the budget of the healthcare system in order to create pressure so that the government will allocate and pay more money for treating the HCV patients. Oh, and how they master to play the "song" of patient's safety.......

Sometimes I am questioning myself whether keeping the treatment prices extremely high opens the gate for bribery.....
Here is a short extract from Wikipedia about the bribery in medicine (en.wikipedia.org/wiki/Bribery#Medicine)

Medicine

Pharmaceutical corporations may seek to entice doctors to favor prescribing their drugs over others of comparable effectiveness. If the medicine is prescribed heavily, they may seek the reward the individual through gifts.[7] The American Medical Association has published ethical guidelines for gifts from industry which include the tenet that physicians should not accept gifts if they are given in relation to the physician’s prescribing practices.[8] Doubtful cases include grants for traveling to medical conventions that double as tourist trips.

Dentists often receive samples of home dental care products such as toothpaste, which are of negligible value; somewhat ironically, dentists in a television commercial will often state that they get these samples but pay to use the sponsor's product.

In countries offering state-subsidized or nationally funded healthcare where medical professionals are underpaid, patients may use bribery to solicit the standard expected level of medical care. For example, in many formerly Communist countries from what used to be the Eastern Bloc it may be customary to offer expensive gifts to doctors and nurses for the delivery of service at any level of medical care in the non-private health sector.[9][10]

This last paragraph really makes me sad....

mgalbrai wrote:
Interesting situation now for us in Australia where the meds are PBS listed.

Moral question:

"Do I pay the PBS price, that is not very much if you are working, and let me and my fellow citizens fork out the rest through taxes, or do I pay significantly, but not extravagantly more, for generics?"

The answer in all commonsense and justice is use the PBS, but it's still something difficult for reasonable people to get their head around I should think.

I wonder if the high paid 'executives' of big companies burden themselves with these types of questions?

J.

Interesting question J,

In the Australian case*, what we have heard from the advocacy groups is that the PBS (correctly taxpayers) are apparently paying a total of A$1 billion for up to 65,000 treatments over the next five years with any treatments above that quantity being provided at nil cost by the pharmaceutical companies. Keep in mind that those numbers are supposedly "per treatment" rather than per 12 weeks of a particular drug although I assume there will also be some sort of rollover and annual quotas fine print in the agreements that attempts to favour the company bottom lines. Overall though, that works out to less than A$16k per treatment assuming we get the full numbers treated and as low as A$4.5k if we manage to treat every one of the estimated 230,000 with HCV in this country. The latter being an unlikely but worthy goal.

Those costs are still quite high for a drug that costs less than US$100/A$130 to manufacture and up to nearly 10x higher than generics pricing however given the capped pricing and the Australian government's likely continued adherence to patent laws a reasonably strong case can be made for advocacy for as many Australians as possible to access what is effectively a fixed level of PBS funding within the five year period. i.e. Once we hit target taxpayers don't fork out any more for extra patients to treat so effectively we are renegotiating a lower pricing structure for each extra person.

(* I believe that the improved access/pricing situation in Australia, while no doubt due to some hard headed negotiations by our government, was enabled because of some very effective grass roots advocacy for generics by a couple of Tasmanians and some NSW pharmacies that definitely were not funded by big pharma )

James-Freeman-facebook wrote:
That seriously makes me want to vomit. Or punch something. Or maybe both. In no particular order. No wonder the world is in an uproar

Gaj wrote:
Hi Gaj,

A part of me (near my back pocket) thinks that if the government spent my hard earn't tax money more wisely, they could even reduce this bill further, say to $1600.00 per head, by buying generics.

Could not agree more about the Tasmanians and New South Welshmen.

Pity Gilead does not have the patent on nuclear weapons and the like.

Yours

J.

Another article that just does your head in. I agree M....what a mess. The inevitable increase in the cost of health insurance will just keep everyone trapped in this complicated, messy cycle unless there are more circuit breakers like Dr F and the generic meds.

What a statement from Gilead's spokeperson. " Gilead's grant program is not a commercial strategy". Seriously?

Just a quick thought about Big Pharma's money and ..... the EASL conference from Paris taking place soon.

After the ILC Barcelona when Dr. Freeman presented the REDEMPTION results and the wonderful press release that followed immediately stating that HCV generic medication is same efficient as the branded treatment, I was hoping that all future EASL conferences will insist more and more on the role of generics.

But now, when I see that this event from Paris is being sponsored by Big Pharma, I kind of lost my hope... I really hope I am wrong on this one. The program of the conference may be found here: www.easloffice.eu/office/paris2016/mobile/index.html#p=1

Cheers,
RHF

It's only activism that will make a difference in the suffering of HCV patients.

The western countries have the patent system that allows for a monopoly for many years. In the case of the USA, the government will not introduce any sort of price controls.

All of my Doctor's were surprised to hear of the insurance denials. They were all interested to hear how I was able to cure myself.

Gilead CEO made $1 billion dollars last year. That is truly absurd.