Should the VA collaborate with the DoD to medevac the most seriously ill veterans with HCV to another country on Air Force cargo/hospital planes? Taxpayers would save an enormous amount of money if so.
This would also be a great project for any veteran service organization to sponsor. If big pharma wants to screw veterans, the VA should just outsource treatment to another country where Solvaldi is much cheaper. Fly the vets in, spend a few days for exams, fly home, then consult via a virtual service like Skype with foreign docs working in partnership with VA hepatologists.
The cost for a 12-week course of Solvaldi differs drastically depending on where you receive the medication.
United States: $84,000; Germany $66,000; France: $50,000; Russia $45,000; United Kingdom: $34,000; Thailand-$5,000; Eqypt-$900. India, Egypt and Brazil: $840; Burma, Iran, Mozambique, and Kenya: $900.
Indian HCV activists are asking the government not to give Gilead an Indian patent because it’s so cheap to manufacture ($68 -$138) for all twelve weeks of treatment. I hope they win.
Forbes writes about medical tourism to places like Bumrungrad Hospital but sticks up for the insane US $1,000 per pill cost which has led to a policy of rationing at the VA. Would one such heavily publicized “Solvaldi for HCV veterans” medevac trip bring costs down?
Do you think veterans would pack a suitcase and board a well-equipped C-17 to another country for immediate treatment? I do. Chicago to Sao Paulo is 10 hours and with no jet lag due to being in the same hemisphere.
The VA cannot afford to pay full price for Solvaldi because it’s NOT an insurance company. We have the planes. We have medics. Bernie Sanders, what do you say?
How do you get the money to pay for treatment? I say do what Brazil did. They used the fact that Hep c was integrated under the HIV program. They changed a few people, Then they demanded equality (they even changed the logo from a red ribbon to a half red half yellow ribbon), which allows them to share “resources”.
I don’t think you’ll have to go to a different country to treat if you play your cards right.
By July the FDA will approve Gilead’s combination of Sofosbuvir with Ledipasvir. In August the EMEA will approve Bristol-Myers Squibb’s Assunapravir with Daclastavir and probably by the end of the year AbbVie will obtain approval for theirs. By 2015 other drug companies will get approval for their treatment drugs, all of them oral and without having to use interferon with a treatment duration between 8 and 12 weeks (and in a few cases 24 weeks). They will be able to treat all genotypes, cirrhotics, non-responders, co-infected and transplant patients.
So by next year we will have 4 or 5 drug companies fighting over the same patients, which won’t be 170 million (the number of people infected with Hep C) because most of them haven’t been diagnosed yet (it is estimated that to diagnose 50% to 70% of those infected, it would take about 7 years but major screening and diagnosing campaigns would have to be used).
Countries with centralized purchasing of drugs (like Brazil), will have greater bargaining power because if the government buys only from one drug company, then that leaves only the private market (about 5%), for the other drug companies to sell their drugs to. Countries where the different regions buy drugs separately will loose some of the power to negotiate prices because they’ll be buying smaller amounts. Other countries like Australia, won’t even consider using the new drugs until they use the supply of PI’s they already bought (Australia paid 50 million for all the Telaprevir they can use in 4 years).
India and Egypt will receive a “compassionate use” much lower price. Egypt already signed an agreement that will give them 1 million treatments over the next five years at a cost of $330 per month…..a 99% discount from the US price.
As for India’s advocates trying to stop Gilead’s patent… Medecins du Monde is an independent org and I doubt they were really trying to stop Gilead from getting the patent because that would delay getting the meds to the patients by 2 to 3 years. Why would you want to do that when you can negotiate a low price with Gilead? I think it was just a great bargaining tool.
“The VA cannot afford to pay full price for Solvaldi ”
The VA never pays full price for anything. They always make deals with drug companies.
Going to Brazil won’t work because their government buys their drugs and controls distribution. I think the answer is simpler. Wait to treat, if you can, until there are several drugs approved. I bet competition will lower the prices so they are, at least, comparable to interferon treatment.
Thank You for this good information.
Great response. I’m sure the VA will haggle but it’s shouldn’t have to. If the pills are really worth 90% less in some low income markets, why not just set a fair price for all the Western countries. Is it possible to find out what the VA pays for individual drugs? Some gov. database?
Two weeks ago a previous PA who was treating me when I suddening became a member of the Hep C club thanks to quality VA medical treatment. Has volunteered to present my case for authorization of a solosbuvir/ribavirin treatment with my local VAMC. Due to my 1B genotype ,I guess it is the 24 week program.So to state the obvious I just sent her this week my authorization letter to submit me for the program. Only stipulation I had was since I HAVE NO support system, they needed to know I must still be able to do my everyday activities like feeding/breathing on my own. Those unnecessary side effects like those which come with interferon can not tolerated. So hopefully I will be one of the first in my neighborhood to get this new funky drugs.( HMMM if I get cured do I still get my back pay for the hell this virus has already put me thru??) Loss of family/friends and a whole lot of changes in my lifestyle should still be worth something! But Hep C free would be worth 30% Disability loss! Mikey