[Ip-health] The Cost of Exclusion

Priti Radhakrishnan priti at i-mak.org
Mon Sep 15 05:38:35 PDT 2014

I-MAK has analyzed the cost implications of the licenses announced today by
Gilead Sciences on the Hepatitis C drug sofosbuvir. The 3 page report is
available here: *http://tinyurl.com/mq35xdl <http://tinyurl.com/mq35xdl>*

Gilead is reportedly excluding 51 middle-income countries (MICs) from its
license for sofosbuvir, an oral hepatitis C drug. Across these MICs
<https://mail.google.com/mail/u/0/#148771184ad8acd4__ftn2>, where nearly 50
million people are infected with hepatitis C virus (HCV), lack of access to
generic sofosbuvir will increase the total cost of curing hepatitis C by an
estimated *$60 billion dollars, *according to I-MAK’s analysis.


I-MAK’s team based this estimate on generic price projections for
sofosbuvir (~$135-400 per 12-week course of treatment), and the assumption
that Gilead’s MIC price would be ~75% more than the $900 price they are
expected to charge to low-income countries.
<https://mail.google.com/mail/u/0/#148771184ad8acd4__ftn5> Even if Gilead
were to extend its $900 access price to all middle-income countries – which
is unlikely – these countries would still need to spend ~$30 billion more
to treat their HCV patients than if generic versions of sofosbuvir were
available. This underscores the need to address patent barriers for
sofosbuvir to make HCV treatment affordable for these middle-income

We emphasize that the middle-income country price we used of $1,567 for
sofosbuvir (with the 75% price premium) is a low-end estimate, and reports
indicate that excluded countries have been quoted a much higher price (e.g.
$7,000 for sofosbuvir). Therefore, the $60 billion estimate is likely to be
very conservative indeed.

Leaving large populations untreated instead of curing them will allow the
epidemic to keep spreading. To meaningfully contribute to the solution,
Gilead Sciences will need to reduce its price of sofosbuvir and promote
robust generic competition in the 51 middle-income countries it has
excluded from the license.

*Priti Radhakrishnan*
Co-Founder and Director of Treatment Access, I-MAK
Echoing Green Fellow | Pop!Tech Fellow | Asia Society Associate Fellow

*"Where innovation meets access to affordable medicines"*

*Website: *www.i-mak.org
*Skype:* pritiwho
*Mobile:* +1 917 703 2876
*E-mail:* priti at i-mak.org

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