$750 A Pop: Price Gouging and HIV Medication Access

Sam. I’ve been following the 2016 presidential campaign season more closely than any other in my life. My Facebook newsfeed seems to be almost exclusively filled with articles about Bernie Sanders, Hillary Clinton, or Donald Trump. So it wasn’t surprising when I came across another article mentioning a statement from Hillary Clinton while making my morning social media rounds. I stopped for a second when I saw that she wasn’t talking about the normal hot topics – climate change, immigration, Planned Parenthood, Trump, etc. – but rather drug prices, specifically the case surrounding Turing Pharmaceuticals.

Reading the article, I saw why this case had gotten such national exposure and had even caught the attention of presidential candidates. Daraprim, the sole curative drug treatment for toxoplasmosis, was priced at a relatively affordable $13.50 per pill last week and overnight rose to the absurd price of $750 per pill. While I had heard that pharmaceutical companies often set ridiculously high prices for their drugs to offset the high cost of development and research, I had not realized how expensive the drugs often became. For those with toxoplasmosis (which tends to afflict people whose immune systems are affected by chemotherapy, pregnancy, or HIV), the cost for treatment became over 5000% higher than it was just days prior. Unfortunately, this disregard for public health is not uncommon.

The 2013 documentary “Fire in the Blood” focuses on the international issue of Western pharmaceutical companies aggressively denying countries in the global south access to low-cost HIV/AIDS drugs in the years following 1996 — an action that has resulted in the death of millions of people living with HIV. While programs such as Ryan White’s AIDS Drug Assistance Program (ADAP) help increase access to medication in the U.S., in 2011 only 40% of newly diagnosed individuals were engaged in HIV medical care and only 37% were prescribed antiretroviral treatment. A part of the problem is that for those whose yearly income disqualifies them from drug subsidy programs (the ADAP cutoff is $22,000 yearly income), the estimated monthly cost for HIV treatment without insurance ranges from $2,000 to $5,000 with an estimated lifetime cost of $379,668. Price gouging such as the one of Turing Pharmaceuticals and other companies only make this hefty medical expense even more difficult to pay and may leave more people untreated. Revenue from sales of Daraprim have risen from just about $700,000 in 2010 to nearly $10 million in 2014, and if Turing Pharmaceuticals decides to stand by the new price, the revenue in future years will likely be in the hundreds of millions. Increasing revenues, however, has come with a decline in sick patients receiving the medication, from 12,700 prescriptions in 2010 to 8,800 in 2014. The number of people receiving this life-saving treatment may continue to fall as the price continues to rise. This same pattern of increasing prices and decreasing prescriptions can be seen with many other drugs and demonstrates all too clearly that some drug companies value profits more than getting patients the medicine they need.

In response to this case, presidential candidate Hillary Clinton announced she would cap out-of-pocket prescription drug costs at $250 per month and candidate Bernie Sanders spoke on his policy plan to reduce brand monopoly powers that generics off the market. While both of these plans would certainly be a move in the right direction, the needed change will not happen overnight the way that the Daraprim price hike did. For the millions of people living with HIV around the world, access to affordable medication should not be something for multi-national companies to decide. Access to such life-saving medication should be a human right.

While the Turing Pharmaceuticals case is not pleasant, the media coverage and attention it’s receiving has had positive implications. The more public outcry and political pressure there is on the issue of inequitable health care costs, the more likely we are to see a change. And that may already be happening, as Turing’s CEO announced last week that they will not be keeping the price at $750 a tablet. Additionally, AIDS activism and the introduction of generic alternatives to some drugs have led to a drop in the price of some HIV/AIDS drugs around the world. The availability of cheap antiretroviral drugs has helped provide around 8 million people living with HIV in low to middle-income countries with treatment to help manage their condition. And hopefully, with more pressure on these companies and further policy change, we can see cases like Daraprim become less and less common in the fight for universal access to HIV/AIDS pharmaceuticals.

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