Monthly Archives: May 2015

Sanders Takes Aim at Drug Patents

By: Marcus J. Hopkins, Blogger

Bernie Sanders (I-VT) is, if nothing else, a bombastic figure in the modern political three-ring landscape, and while most of his supporters applaud his penchant for speaking “truth to power,” rarely does the Independent senator from Vermont garner support from both sides of the aisle. Last week, however, he may have managed to curry some favor with HCV advocates across the country.

In a letter to Robert McDonald, the U.S. Department of Veterans Affairs Secretary, Sanders implored the VA to use its emergency powers to break – or override – the patents for HCV drug therapies currently held by Gilead (Sovaldi and Harvoni) and AbbVie (Viekira Pak). This move, while within the legal purview of the Federal government, is unusual, almost to the point of being unprecedented; Sanders argues (and rightly so, in my opinion) that the health and wellbeing of our nation’s veterans should serve as sufficient motivation for exercising the measure.

Photo of U.S. Senator Bernie Sanders

Photo Credit: CNN Money

As we’ve covered in this blog many times, the high cost of HCV medications continues to create a furor amongst both private and public payers, so much so that both Medicaid and the VA contend that they cannot remain solvent if spending on these treatments remains constant or increases over time, and with no relief in sight (at least for Western nations), breaking the patent may, in fact, be what it takes in order to force pharmaceutical companies to lower the prices on their drugs.

If this suggestion seems a bit extreme, it isn’t the first time that Sanders has advocated for something so patently (pun intended) antithetical to the current understanding of the American economy. As a self-described Democratic Socialist, Sanders often stands far to the left of where most modern politicians like to place themselves – decidedly rightward, that is – and his open admission of his political leanings often relegates his suggestions to the top of the “Not in a Million Years” inbox. That said, Sanders’ populist message has been gaining ground over the past few years, in no small part because of his staunch opposition to what he deems an outsized influence of money upon the American political system.

LOGO: Socialist Worker's PartyThe response to his suggestion has been…well, mixed, at best. Many commenters to a May 12th, 2015 article in the Wall Street Journal (WSJ) responded with outright fury at the mere suggestion that patents be broken, which isn’t entirely surprising, given that the WSJ is a publication whose very existence is owed to the making of money.

WSJ readers responding negatively to Sanders’ plea comes as no surprise, given the Journal’s decided pro-Capitalism/Free-Market/Free-Trade brand of “journalism.” Too many readers of the Journal, the very thought of Socialism is enough to send them into a faux patriotic tirade, spewing nonsensical conspiracy theories and spreading the gospel of doom, should the so-called “Free-Market” ever be dismantled by the clearly Communist policy positions of someone so obviously “Red” as Sanders.

The primary “concerns” revolve primarily around whether or not breaking patents would serve as a disincentive for pharmaceutical companies to keep making products. Overriding the patents will, they aver, cause these companies to (and I quote), “…[never] bring another drug to market, again.”

Never mind the fact that the U.S. is the greatest contributor to the profits of these companies, and pays exponentially more than any other nation in order to prop up these companies’ very existence, and virtually no other country on the planet agrees to pay the rates we pay in this country, because they’re absurd. Also, never mind that there has never, in the history of patents and patent breaking, been an example of an industry completely folding and refusing to innovate because patents were broken.

But, I digress.

In terms of shortfalls, the VA has already reallocated $400 million on HCV drugs, but is in desperate need of more funds, and has recently petitioned Richard Blumenthal, the ranking member of the Senate Committee on Veterans Affairs, for permission to repurpose yet another $400 million in its budget for the drugs. If even that sounds a bit extreme, the VA insists that, even with $800 million (assuming the proposed reallocation is approved) it will barely scratch the surface of what is becoming a burgeoning epidemic.

Neither Gilead, nor AbbVie responded to requests for comment from the WSJ, and a spokesman from the VA, when asked if Sanders’ proposal was under discussion, deflected the question by referring instead to the work the VA’s doing with Congress to find ways to address the financial shortfall.

If that’s really the case, woe to the VA.

While Sanders’ plea may not be realistically feasible, given the fervor and dogged determination of American politicians to discredit and demean all things “Socialist,” it does raise an interesting question – “How much is too much to take care of our nation’s veterans?”

The VA is, much to the chagrin of the anti-Socialism red-meat-eaters, one of the few examples of Socialized Medicine in the U.S., and by most measures, it continues to fail at providing consistent, continual, and (most evidently) timely care to veterans. This is largely a product of continual underfunding of the program, particularly in a century when we’ve fought two of the longest wars in American history (although, some dicker over whether or not those were actual “wars”).

Ultimately, what it comes down to is a set of choices – (a.) continue to pay the very overpriced cost of HCV medications, and bankrupt the system (a proposal that some may, sadly, find appealing), (b.) continue to pay the very overpriced cost of HCV medications, and attempt to find more money from somewhere (I can think of a certain Defense Department whose budget could use a few hundred billion financial slashes), or (c.) take the proactive stance and call the pharmaceutical companies’ bluffs by breaking the patent to deliver the kind of care that our veterans deserve.

The unfortunate truth is that, regardless of what road is taken, not everyone will be happy. Someone’s going to come out of this war over pharmaceutical pricing the biggest loser, and most likely, it’s going to be the people who can least afford to fight.

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Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.

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Patience vs. Propinquity

By Marcus J. Hopkins, Blogger

If I’ve learned nothing from being diagnosed with HIV/AIDS, it’s that patience is not only a virtue; it’s a fact of life. Things take time, and more often than not, the best possible solution isn’t always immediately available. In the best of all possible worlds, every program would have adequate funding to help those who cannot afford the cost of treatment, and would offer them the best therapies on the market.

But, propinquity – being close to something – is a frustrating circumstance for those of us who have been in the HIV game since the beginning of the epidemic. “It’s 2015,” we huff in exasperation. “Didn’t we already solve all of these access issues?”

And, to be fair, we did solve a lot of the access issues. Now, more than ever before in the history of HIV/AIDS, more people have access to treatment regardless of their income or ability to pay. But, this isn’t something that came to be without a significant amount of work and struggle. Things like these take time, nothing happens, overnight, and despite our penchant for constantly reliving and memorializing the history of the AIDS crisis, we often fail to remember that it’s been over thirty years of struggle to get us where we are, today.

More to the point, those of us who are transitioning over from working in the HIV/AIDS-focused sector to the Hepatitis C world often fail to remember how long we worked to make the HIV treatment landscape what it is, today – broken and fractured, though it remains – and as such, we have this tendency to expect immediate results.

“Of course,” we aver, “HCV medications should absolutely be covered! All of them! Right now!”

A colleague of mine was recently reminded of this reality when we were discussing the state of HCV treatment coverage. What is unique, however, about HCV medications is that they are so far outside of the realm of affordability, it’s virtually impossible to come up with an affordable solution.

It’s certain that I’ve made this comparison, before, but the cost for Stribild (Gilead) to treat HIV, in West Virginia, is $37,000/year; the cost of Harvoni (Gilead) to treat HCV, in West Virginia, is around $96,000/twelve weeks.

Those two numbers are nowhere near comparable, particularly if the first round of Harvoni fails to adequately treat the patient. Additionally, we have far more HCV patients in West Virginia, than we do patients with HIV, and that is going to prove to be the case in virtually every state. So, we’re not just talking about a hundred or a thousand people; we’re potentially discussing the treatment of millions of people. Those numbers add up, and for states with limited resources and no real federal funding, it’s just not feasible to treat them.

And, so…patience. Patience must be the name of the game, when it comes to treating HCV, either for those mono-infected or co-infected with HIV. Yes – the need to treat co-infected patients is urgent and pressing; it is always, for many states, not financially feasible. Realistically, this is why so many states who ostensibly offer coverage for HCV medications like Harvoni/Viekira Pak (AbbVie) have strict “Prior Authorization” requirements – they can really only afford to treat the absolute direst of cases.

It’s a difficult reality for people who’ve worked so hard to create the current HIV treatment landscape to grasp, particularly when we’ve come so far in addressing those issues. We forget how long it took us to get here, and that, even though we have the technology (we can rebuild him), HCV is its own monster, and as such, will have to travel its own long and arduous path.

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Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.

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