This past year, the Food and Drug Administration approved three new treatments for hepatitis C, a previously incurable infection. The medical community was initially excited to finally have a treatment for this condition, since 80 percent of those who are exposed to the virus become chronically infected and are at risk for cirrhosis, liver failure and even death.

The Centers for Disease Control simultaneously directed that everyone born from 1945 to 1965 get tested for hepatitis C, because the greatest numbers of new cases were coming from people in those age groups. 

This led to a dramatic increase in the numbers of people diagnosed with hepatitis C.

New medications from American pharmaceutical companies often cost far more in the United States than in other countries.

Flickr.com

It’s caused by a virus transmitted by exposure to blood and other body fluids. Active or prior IV drug abuse, transfusions or transplants before 1992, or exposure in childbirth or during intercourse, are some of the most common ways the infection is spread. It takes an average of 20 to 30 years to manifest symptoms, and once it does, it’s usually in the advanced stages. Cirrhosis, liver failure, and in some cases liver transplants are the only treatments available at that point. In fact, nowadays, most liver transplants are being done for hepatitis C. 

Initially the news was great: up to a 99 percent cure rate with these new drugs, compared to an approximate 10 percent cure rate with previous medications. Then the price came out:

• $66,360 for 12 weeks of Olysio by Johnson and Johnson

• $84,000 for 12 weeks of Solvadi by Gilead Sciences

• $63,000 for eight weeks of Harvoni (Solvadi plus Ledipasvir) by Gilead Sciences

• $94,500 for 12 weeks of Harvoni

To make matters worse, Gilead Sciences, the company that makes Harvoni and Solvadi, has discounted the price of its medication for 91 other countries. The cost in India is $900 for the same amount of medication that costs $84,000 in the U.S.

That’s a 99 percent discount.

Why should we all be worried about this blatant inequity in cost? Because we are all paying for it.

Most people infected with hepatitis C in the U.S. are not rich. They are on Medicare if they are over 65, or on Medicaid if they are low income. Taxpayers fund these programs.

There are state and federal mandates that require coverage for medications that do not have any other equivalent generic available. This means that for people who qualify for the treatment, the law mandates that it be covered by their insurance company with minimum restrictions.

At the same time, there are laws against any price negotiation with pharmaceutical companies for any federally or state-funded Medicare or Medicaid program.

So we have to pay whatever companies like J&J or Gilead Sciences demand, regardless of how much price gouging they choose to do.

Essentially, the United States is funding treatment worldwide to enrich a small number of shareholders of the biotechnology company, Gilead.

In Hawaii, 23,000 people are estimated to be infected, and therefore potential recipients of these medications.

For a course of treatment, that’s potentially a total cost of $2 billion to $4 billion dollars in this state alone.

Where will the Legislature find the money to cover that bill?

Should we even have to pay so much more than any other country in the world, to a company that’s based in the United States in the first place? How can a company from California purposefully penalize its own countrymen by pricing their drug out of the reach of all of us?

It’s not the first time people in the U.S. have had to pay so much more for their medications. For years, the business community has known that we pay more for the same medication here than in Canada, Europe, Japan or anywhere else.

In addition to the actual cost of the drugs being higher, it is illegal to import the cheaper versions of these medications to the United States.

So the problem lies first with the laws that allow pharmaceutical companies to set prices and make it illegal to demand a lower cost for the drugs. That inability to negotiate for discounting for any state or federal insurance program, including Medicare and Medicaid, has punished every taxpayer who funds this program.

We need to change the law first.

Second, the illegality of importing any of the same exact medication from another country due to its much cheaper cost, is forcing people here in the U.S. to choose between buying their medication, or buying their food. If they are caught importing drugs, they could be put in jail.

Which is ironic, because that’s where they would receive their medication free from the Federal Bureau of Prisons.

The potential cost of these treatments for hepatitis C would bankrupt Hawaii. But we are not alone. Every state is facing the same budget shortfall with this insane cost of treating just one chronic disease.

We just can’t afford it. Not until the laws allow people to bring the cheaper versions into the U.S. legally, which would force pharmaceutical companies to rethink their agenda of reaping their profits at our expense.

Hepatitis C treatment is just the beginning. More expensive treatments are sure to follow this route if we don’t stop this costly insanity now.