Efforts start to bring cost of hepatitis pills down

LONDON A new battle is looming over access to antiviral medicines in developing countries — this time for treating hepatitis C — more than a decade after a global showdown over the price of AIDS drugs in Africa. Modern pills being launched in western markets could cure the liver-destroying infection in tens of millions of people from China to Congo, or even eradicate the disease entirely. But that will only happen if the cost falls dramatically. Drugmakers like Gilead Sciences, whose product Sovaldi won US approval this month with a $1,000 a day price tag, are under mounting pressure to strike deals to avoid a rerun of the disputes that stalled early access to HIV therapy. “Affordability is an urgent and pressing issue,” World Health Organisation (WHO) Director General Margaret Chan said during a visit to London. “These drugs are very expensive. How can we address this? I hope we can learn from the lesson of HIV and find solutions without confrontations.” In the 1990s, HIV/AIDS drugs costing more than $10,000 per patient a year were simply out of reach for millions of people in the developing world. Today, thanks to cheap generics from India, the cost for the poor has been slashed to around $100. Like HIV, hepatitis C (HCV) can be spread through blood, often via contaminated needles. The WHO estimates that 150 million people worldwide are chronically infected, putting them at risk of cirrhosis and liver cancer. But whereas the burden of HIV is largely in sub-Saharan Africa, most cases of HCV are in middle-income countries like China, India and Russia, where drug companies are more reluctant to accept rock-bottom prices. Chan said options for maximising use of the drugs could include granting licences to low-cost generic drug manufacturers in India and other countries, as has happened with HIV drugs and also Roche’s flu pill Tamiflu. Gregg Alton, Gilead’s head of corporate and medical affairs, said his company was working on plans to help ensure access to Sovaldi in resource-limited countries and aimed to set out details early in 2014. Other companies developing all-oral treatment regimens for HCV — such as Johnson & Johnson, AbbVie, Bristol-Myers Squibb and Merck & Co — also recognise they need to tackle the issue. “We are going to be responsible players to make sure that people get access,” said Paul Stoffels, head of pharmaceuticals at J&J.