The High Cost of Hepatitis C Treatment

The high cost of treating hepatitis C with sofosbuvir (Sovaldi) has received a lot of attention in the literature, with some cases attempting to justify the price and others offering suggestions on how to limit the drug’s use.

While I have no particular insight that provides a solution, this whole issue has driven me to ask a few questions, including:

• Who should determine the cost of a drug product?
• Should the price of the disease process play a role in determining a drug’s cost, or should it be based on the price to produce it?
• Should the payer try to influence how the drug is used?
• If society is the payer through a publicly funded program like Medicaid, should the restrictions in a drug’s use differ from an insurance program funded by the patients themselves? In other words, should the source of health care funding impact how a drug treatment is used?
• When a program cannot afford to provide health care to all, how should the decision to ration care be made?

None of these questions are easy to resolve, but it appears they are being answered differently as patients and payers deal with the treatment of hepatitis C with Sovaldi. Is this just a foreshadowing of what’s ahead as we implement nationalized health care? I personally believe so.