Pharma’s Catch22 on access
By James Snodgrass
Advocating for greater access to medicines is an essential activity. It promotes health equity, serves the global health community and challenges the industry to do more. When the industry responds with innovative and pragmatic solutions to some of the more intractable issues surrounding access these need need to be recognised. In a recent review of patent applications for Sovaldi, Gilead’s new antiviral for the treatment of hepatitis C, the problems of access are well rehearsed, but the steps taken towards a solution are ignored. Gilead’s approach with Sovaldi is a story not of access denied, but access extended.
This ignores the existence of by far the biggest hepatitis C treatment programme in the world. In this programme, Gilead is supplying Sovaldi to the Egyptian government at a cost of $900 per course of treatment – only about $400 more than the cost of generic sofosbuvir in India. Clearly Gilead is prepared to discount deeply if there is a large volume of patients available – Egypt has the highest prevalence of hepatitis C in the world, with 14.7 percent of the population infected. The government’s goal is to use this treatment programme to get that figure below two percent. Is it not fair that a middle-income country such as Egypt should pay a little more than than a low-income one?