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This is a similar story to what Cutis Holland faces: (Reuters) - Kaiser Permanente, the biggest U.S. health maintenance organization, said it is using Gilead Sciences' new hepatitis C drug, Sovaldi, even though its $84,000 treatment price is "outrageous."
The medication is widely viewed as a breakthrough that can cure a majority of hepatitis C patients, often within 12 weeks. Analysts project 2017 sales of $9.1 billion, according to Thomson Reuters Pharma.
But Gilead has come under fire, from insurers and Congress, for Sovaldi's $1,000-a-pill price at a time when U.S. healthcare spending is under scrutiny and President Barack Obama's Affordable Care Act aims to make health coverage accessible to everyone.
The company says Sovaldi should create huge savings for the healthcare system over time by preventing complications from liver disease and transplants, but declined requests for evidence to back up those claims. A Gilead executive told Reuters last week that it had an agreement to discount the drug for the Kaiser network, based on their recognition of the long-term benefits.
In an interview, Kaiser officials disputed that view. Kaiser is using Sovaldi "not because we see this as a high-value, cost-effective approach," said Dr. Sharon Levine, associate director of the Permanente Medical Group. "It's because this is a therapy that represents a substantial improvement over existing therapies ... It's an outrageous price for a therapy that has huge public health implications."
She called Kaiser's discount on Sovaldi "modest" and said state Medicaid programs and private health insurers "are going to have to make very serious tradeoffs just based on a single manufacturer's decision on pricing a drug because they can."
Gilead officials declined to comment.
Hepatitis C, estimated to infect about 3.2 million Americans, is a blood-borne virus that can cause severe liver damage.
The following is Curtis Holland's personal story:
In September 1999, I was donating blood for a kindergarten student
and the lab person said, “Mr. Holland there is an abnormality in your
blood sample and you need to see your doctor immediately.” Through
many tests I was informed that I had hepatitis c and stage 4 cirrhosis
of the liver. We concluded this was caused by a hit in the face with a
baseball in 1972 and with many blood transfusions, I received the
disease. And the journey began.
I have been very ill with this
unfortunate matter in my life. I took the drugs Interferon and
ribavirin, a type of chemotherapy. The illness and the effects of the
medication on my mind and body were too much. In 2002 the cost of this
medication was $1,000.00 a month. After 4 months of therapy there was
no change. The expense of the trips to Houston for doctor visits,
parking expense, copay on insurance it is difficult to pay and puts
stress on me and my family.
I have had many battles with
infections and esophageal vericies. Each time infection occurs I am in
the hospital for at least a week to receive antibiotics intravenously
and repair whatever damage was done by the infection. I have to have
surgery once a year for esophageal vericies banding. If I start
bleeding internally before the year is up then it is immediate
surgery.
At this time I am fighting an infection called
celulitus an infection in the fatty deposits of the skin. Just spent
the week in the hospital. The liver team is trying to get me approved
for a medication to cure hepatitis c. Hepatitis c attacks the immune
system and if I did not have this I would be able to fight the
infection myself or not have it at all. I have been told it will give
me back my life. This is promising to me. I would love to have many
years with my grandchildren and I am in this battle not giving
up.
Thank you for your help.
Curtis Holland
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