It is estimated that there are over 3 million Americans living with hepatitis C at this very moment. Of course, there are millions more if you consider the entire world’s population. This means that there is a definite need for fast and effective hepatitis C treatment options that also cure the individual of their infection. Although, it can take years for each new treatment option to reach the public. This is because of a number of factors, primarily rooted in the areas of pharmaceuticals and in value.
How Do Pharmaceuticals Impact Treatment Costs?
The process of going from drug creation to public availability can take years or even decades. A drug company must first recognize a need for a type of treatment. This often comes from observing the concerns that doctors and patients have when interacting with a currently existing drug or when there is a new medical health concern that did not previously exist. An example of this would be, “we need a type of treatment for hepatitis C that provides the same efficacy rate as the current drugs on the market but without the specific side effect of exhaustion/depression/etc.” or “a new set of medical symptoms was just named; we need to create a drug to cure or treat it.”
With this goal, drug companies choose specific research employees to begin the process of drug creation. This includes surveying patients on other drugs or patients who are currently ill with the condition in order to best understand their future customers’ needs. Scientists are also studying the illness from the laboratory to understand as much as possible about how the illness exists, from how it is spread to how it replicates within the body and the internal damage the illness causes. Then other scientists work on creating a treatment that takes all of this information into consideration. This process can take years. When these scientists believe they have created something that will work, a new team of researchers perform tests on test subjects. These typically begin with an animal that is given the medical condition so that researchers can study how the drug impacts the condition and the body during treatment.
Often, drugs have too many side effects or are found to be ineffective at this stage, which causes researchers to go back to work to try again. When the drug works, new test subjects are evaluated. Eventually, if the drug passes enough tests with scientists and animals, humans are brought. These people can help researchers to understand the drug experience, considering all side effects and efficacies on the illness. If the drug passes these tests, it is given to the governmental board for approval. Each nation has its own approval process. This process can take months and drugs that are to be used internationally must pass each country’s own approval process. It can take years before the drug can be approved for worldwide use.
At each step, millions of dollars are invested into the drug by the pharmaceutical company that is creating it. The company is incentivized by an agreement that they will have the exclusive right to sell this formula for a predetermined period of time, typically 3-7 years. The company invests in the drug process with the belief that enough people will need the drug and pay to use it that the company will make its investment money back and make a significant profit. After their monopoly on the drug ends, generic forms of the drug can be created by the same company or another company. When this happens, the price of the drug can decrease significantly, as there are numerous companies manufacturing and selling the same drug formula. However, by the time this occurs, there may be other newer or better drugs on the market which are now in their own monopoly stages. This can mean that people who are wealthy have access to drugs that poor people do not and that wealthy people can be saved from lengthy illnesses or long-term organ damage from hepatitis C and poorer people are forced to sit in illness until the drug becomes inexpensive enough to be affordable to them.
How Does Value Impact Treatment Costs?
When pharmaceutical companies are considering whether to invest in the creation of a drug, one of the areas of focus is on the treatment’s value. The company researches whether the illness is impacting wealthy people who will pay significantly out of pocket for this drug without hesitation. It also researches how awful someone’s life would be if they do not have access to the drug. In the case of hepatitis C, drug companies know that treating the hepatitis C virus quickly is important for liver protection and to keep the body from experiencing other medical problems, some of which could be permanent. The drug companies know that some people who have hepatitis C and do not receive treatment end up needing a liver transplant and that they could die due to such severe liver damage.
The drug companies then decide that they can make money both from the wealthy who do not hesitate to spend money for treatments and cures and from those with less money. This is because some state government assistance programs will cover a drug treatment now in order to prevent having to pay for costly liver tests and treatments or transplants in the future. The drug companies also know that those without wealth but who do not qualify for government assistance will see the necessity in accessing the drug and they are likely to find a way to pay for it, whether it is by working a second job, mortgaging their home, or selling their belongings. The drug company can then recognize that people of all income levels are likely to purchase their product and that makes it likely to perform well enough in the market to recoup the investment and to make significant profit.
What Can The Average Hepatitis C Patient Do About It?
Currently, doctors are able to prescribe any medication regimen they believe is best for their patient. If you are someone who is not wealthy, it is important to discuss your financial concerns with your doctor at your appointment. If you currently have insurance, either private or government assisted, you should contact them directly to discuss your coverage and what medications and treatment options are covered under your plan. These options may include non-drug based treatments, including meetings with a dietician to help with nutrition planning, gym membership coverage to help be as fit as possible during treatments, or mental health care coverage to assist with the common feelings of depression during the treatment regimen. Make sure to get everything you learn from your provider in writing so you and your doctor can look at this information together. This can help your doctor to choose a treatment plan that fits your personal medical records as well as your personal budget.
If you would like to find a way to make an impact outside of your own treatment needs, you can contact your local politicians and encourage them to consider the cost of these drugs when they provide funding to local clinics and government assistance programs. You can also contact your health insurance provider to voice your opinion regarding their coverage of hepatitis C medications. Although this may not seem immediately impactful, people will listen if they receive the same feedback often enough.1-6
Almendrala, A. (2015). This Is Why Hepatitis C Drugs Are So Expensive. The Huffington Post. Retrieved 23 July 2016, from http://www.huffingtonpost.com/entry/why-hepatitis-c-drugs-are-expensive_us_5642840be4b08cda34868c8a
Court, E. (2016). This is the most expensive drug in America. MarketWatch. Retrieved 23 July 2016, from http://www.marketwatch.com/story/this-is-the-most-expensive-drug-in-america-2016-04-09
Cutler, L.Ac., N. (2016). Hep C Drugs in 2016: More Combos and Lower Cost. Hepatitiscentral.com. Retrieved 23 July 2016, from http://www.hepatitiscentral.com/news/hep-c-drugs-in-2016-more-combos-and-lower-cost/
Kurtzman, L. (2015). Expensive Drugs That Cure Hepatitis C Are Worth The Cost, Even At Early Stages Of Liver Fibrosis. UC San Francisco. Retrieved 23 July 2016, from https://www.ucsf.edu/news/2015/11/287551/expensive-drugs-cure-hepatitis-c-are-worth-cost-even-early-stages-liver-fibrosis
Robbins, R. (2016). Inside the huge ad blitz for a $1,100-a-pill hepatitis C drug. STAT. Retrieved 23 July 2016, from https://www.statnews.com/2016/03/08/harvoni-hepatitisc-ads/
Sifferlin, A. (2014). Why Hepatitis C Drugs May Soon Get Far Less Expensive. TIME.com. Retrieved 23 July 2016, from http://time.com/3643996/hepatitis-c-drugs/