Call me the Nostradamus of health care, as I did warn of impending doom. I said one of the ramifications of socialized health care in the U.S. would be treatments which only the privileged could afford. I know you didn’t believe me then; you wanted to believe the politicians and pundits who were selling equality through entitlement…yeah right…and I’ve got a bridge for sale. So as I, Nostradamus, have predicted: medical innovation will continue to boom. Case in point: we now have our first serious hepatitis C cure, but reports have its price tag listed at $1,000 per pill. Egads…and a full treatment may cost along the lines of…ya ready?…gulp…$90,000! Yes and even better: it probably won’t be covered under Obamacare.
The new pill, called Sovaldi, apparently cures nine out of every ten patients treated for liver disease caused by the hepatitis C virus (HCV). An estimated 150–200 million people worldwide are infected with hepatitis C, a virus that infects the liver and which, when chronic, can lead to liver failure, liver cancer, or life-threatening esophageal and gastric varices. The virus is spread blood to blood, so from intravenous drug use (sharing needles), dirty tattoo parlors, and blood transfusions (see photo below). People who do develop cirrhosis or liver cancer may require a liver transplant.
Because the infection is often without symptoms, many of the 3 million Americans that carry the hep C virus don’t realize it. And even though no conclusive evidence shows HCV to be transmissible by sexual intercourse, multiple sex partners is in fact a risk factor. In 2007, it surpassed AIDS as a cause of death, as an estimated 15,000 people died in the U.S. from complications associated with the infection.
While the discovery of Sovaldi is a godsend for anyone infected with HCV, the cost is something that brings to light the ugly realities of a new system intending to curb health care cost. Insurers, naturally, are balking at the price. Dr. Sharon Levine, a top official working on drug policy with insurer Kaiser Permanente, believes the price is out of line. She notes that countries where the government sets drug prices are paying much less. And while U.S. insurers aren’t interested in price controls, said Levine, “eventually the American public is going to start getting very uncomfortable” with high prices.
The California Technology Assessment Forum, a private group that reviews medical treatments, recently voted Sovaldi a “low value,” because it would be cost-prohibitive to treat the high number of potentially eligible patients. But after their own assessment, the Infectious Diseases Society of America and the American Association for the Study of Liver Diseases issued clinical guidelines recommending that doctors use Sovaldi as a primary treatment.
See the conundrum? Remember my words from February 2012 when I said, medical innovations will continue to flourish provided we do not try to curb costs. The socialist in us all can cry equality til we’re blue in the face, but the cold, hard fact is that drug research and development (R&D) is costly. If pharmaceutical companies cannot turn a profit, then expect innovation to fall in the lap of…gulp…academia. And well…ya know…
But if medical technology is allowed to flourish on its own, well then it is going to cost, especially for a big gun like Sovaldi. Drug maker Gilead Sciences, Inc., reported Sovaldi sales of $2.3 billion worldwide in just the first three months of this year. Gilead will not disclose its pricing methods, but vice president Gregg Alton said the drug’s high cure rate makes it “a real huge value.” As it should be.
Listen folks, I’ll say it again, you can’t have it both ways. You want ground-breaking medical science—bionic eyes, magic penis pills, and cure-me-from-instant-death-NOW medicines? Those cost ducketts. But if what you want is everybody gets the same…it ain’t gonna be Sovaldi, sorry. Anyway, it’s a rhetorical question because we human beings will not stifle progress ever—we can’t; it’s hardwired in us. But we can create greater discrepancies between the haves and have-nots. Trying to lower health care costs to satisfy insurance industry interests will be the greatest driver of that discrepancy. So say I, Nostradamus.