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:

https://testandtreathepatitisc.files.wordpress.com/2015/03/indian-generic-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.

http://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.

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

Hello Alsdad,

This article http://timesofindia.indiatimes.com/india/Desi-generics-firms-pave-way-for-cheaper-hepatitis-C-drug/articleshow/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:

http://www.wpro.who.int/hepatitis/resource/features/2015_walshetal_hepc_avoidasiamissingout.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

http://blogs.hepmag.com/gregjefferys/2016/01/hepatitis_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.

[video]https://www.youtube.com/watch?v=Otm4RusESNU[/video]

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.

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 ), 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?

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.

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.