Topic: Senate Committee on Veterans’ Affairs, Hearing: Hepatitis C Medications. December 3, 2014, 11:30 a.m.. LINK–video doesn’t start until 21:41. The video content varies from the written testimony (Link below). I believe that viewing the video will be a worth your time. I give the hearing:The lawmakers questions are commonsensical (no grandstanding) and the panelists are given time to answer them.
There are also a number of interesting facts in Senator Sander’s written statement (4-pages here): I learned that we the taxpayers (via the federal government) helped the lead researchers develop the drug with $18 million dollars when it was Pharmasett (now known as Solvaldi). Then the developers sold it to Gilead for $11 billion. They expect to make about $200 + billion on this investment in a very short time because the medication costs an “astounding” $1,000 a pill or $84,000 for a 12-week treatment. The VA has negotiated a discount yet still pays $539.00 per pill.
Bernie compares the VA’s discounted cost with the cost of $900 per treatment in developing countries. Calling these sweetheart deals with foreign governments, Bernie asks “…is it really fair that these countries receive such a generous–and affordable–price while our veterans do not?” The VA has had to ask Congress for $1.3 billion to treat veterans with HCV. The VA is also going to be forced to ration the medication. There are approximately 174,000 known HCV patients but it’s not clear to me what percentage of them have chronic, active infection. 42K vets in VA care are estimated to also be infected but are as yet untested.
With characteristic chutzpah (in the positive sense) and the U. S. Constitution as his shield, Sen. Sanders doesn’t mince words in his written criticisms of Gilead. (And that’s why Vermonters will keep the ornery and independent Bernie Sanders in office for as long as he wants to serve.) On the issue of corporate greed he says:
…Drug companies charge what they think the market will bear. Gilead clearly made the calculation that they could charge excessive prices for this ground-breaking drug and that the federal government will pay.
We’re looking at a company that is milking a cash cow for everything it’s worth. Gilead could give Solvaldi to the VA and the impact on their profits would be marginal.
Companies like Gilead are gouging the American consumer and the American taxpayer and they are ignoring any sort of moral obligation to help very sick people access life-saving medications…our veterans deserve better.
We’re all going to be footing these bills (VA, Medicare, DoD, Medicaid, private insurance, prisons, etc..). I was pleased to note that the only exposures to HVC infection Bernie mentioned for olders vets were from blood transfusions and reused needles (verbally) with special mention of combat exposures (written). Recall my post linking to a 1973 official study that showed that IVDU drug use in Vietnam was rare. The VA says that those not infected decades ago, that is, most NEW infections they’re seeing (20K per year), are from IVDU. Drug addiction is horrible in itself but they must to get these vets into addiction treatment first (and clean) before they can receive anti-virals. So there is hope in these urgent interventions.
Read other testimony here. Other notes:
VA’s Dr. Valentino’s testimony (around 39 minutes) gives an overview on new meds in planning and challenges. If Congress gives $1.3 billion for the new HCV treatments, only 25-35,000 veterans can be treated at current prices. The high cost of these drugs is not sustainable for the VA. Rationing in the private sector is also taking place. R & D costs for the product were only about $100 million and manufacturing costs are about $150-250 per person. How do we get to $84,000 per person, asks Bernie. The answers: the patent monopoly, “escalator pricing” with no relationship to R & D costs, and desperate people. This situation is not rational, efficient, justified or moral. Medical tourism is discussed and is something insurers are even looking at.
I’m looking forward to working with Bernie’s staff on HCV veteran issues when we return to Vermont in a few months. If the cost of these drugs become affordable, and HCV-veteran research doesn’t stall, I think we have a shot at having HCV recognized as a presumptive disease associated with military service for many Vietnam-era veterans before we kick the bucket.