Medications that cost 250$ in production while manufacturers try to give it a 3600$ price tag

The Egyptian Initiative for Personal Rights (EIPR) today called on the government to develop effective policies and resort to multiple approaches, including newly discovered medications, in order to reduce and then eliminate viral hepatitis C (HCV) and its enormous prevalence rate of 14.7 % of the total Egyptian population (around 12 million people).

In a meeting, held today at the request of the multi-national pharmaceutical “Gilead” that manufactures the new anti-HCV drug Sofosbuvir, an EIPR team of experts in health policy and systems stressed on the importance of developing a comprehensive policy to confront the burden of this disease in Egypt.

There are numerous parts that could together constitute a comprehensive policy to tackle this disease in Egypt on the basis of sound scientific research and reliable clinical evidence that follow national and international standards, EIPR said. Alternatives include purchase of new medicines at affordable prices, local production with voluntary licensing or even through compulsory licensing.

EIPR believes that the Egyptian government should negotiate with the new drug manufacturer from a position of strength as this drug cannot be imported without receiving an Egyptian license and conducting the needed clinical trials. Egypt has the highest prevalence rates of HCV infections in the world, therefore, any agreements concluded will open the door for the product’s world-wide sales.

The company's request to meet with EIPR followed the first Hepatitis C World Community Advisory Meeting[1] in Bangkok last week, which included 38 representatives of civil society from 22 countries with support from the World Health Organization. EIPR actively participated in this meeting which demanded that the six largest pharmaceutical companies in the world provide medicines for the treatment of HCV infections at reasonable prices, thus helping prevent the death of 350 000 people each year. So far, the pharmaceuticals have declined to offer the new medicines at a price that could make it affordable to the people and governments of developing countries.

Gilead team is currently visiting Egypt to hold talks on Sofosbuvir. EIPR warned the government to accept commercial arrangements that could foreclose the possibility of local manufacture of generic drugs for several years, or make the costs of importing it to treatment the vast majority of people living with HCV infections in Egypt prohibitively expensive.

EIPR believes that it is within the national pharmaceutical industry’s reach to manufacture local generic medications in the near future, especially as they were able to manufacture a generic, local Interferon few years ago. However, this option requires the government’s abstention from granting licenses for Gilead or other companies if an affordable price is not agreed upon.

Experts in the pharmaceutical industry believe that a mutual agreement for local manufacture of the drug at an acceptable price is possible specially in light of the academic estimates that the actual cost of production of the complete treatment course does not exceed 250$[2] while the price tag presented by the company last week in Bangkok reached 3,600$ for middle income countries like Egypt.

EIPR said the position of multinational pharmaceuticals on drug pricing indicated extreme greed that will end up making these new medications completely out of the reach of the majority of the affected populations, whether directly through their out-of-pocket expenditures , or through state funding mechanisms such as national health insurance plans.

EIPR therefore calls for Egypt to begin working with other countries that suffer from HCV high prevalence such as India, China, Pakistan or Indonesia, in order to reach a reasonable arrangement that enables the provision of this medication at an affordable price that matches the budgets of these states and the resources of their citizens, since any agreement with Egypt will affect the situation of nearly 160 million people living with this disease in the developing world.

In fact, the collaborative work of civil society organizations and governments had directly contributed to the reduction of HIV / AIDS drug prices from 10,000$ per patient to only 100$. The same outcome is possible regarding anti-HCV medications.

EIPR sees that the proper, sustainable remedy to viral hepatitis is to empower national industries and not to easily succumb to global monopolies of multi-national patent-holders. We need to be inspired by success stories from other developing countries that suffer from similar burdens of diseases such as India and South Africa .

The right to access to medicine is an integral component of the right to health. This right has been recognized by international conventions and finally by the Egyptian Constitution in its latest amendment.

[1] http://www.actupbasel.org/actupbasel/?First-Hepatitis-C-World-Community

[2] Hill A, Khoo S, Fortunak J, Simmons B, Ford N. Minimum Costs for Producing Hepatitis C Direct-Acting Antivirals for Use in Large-Scale Treatment Access Programs in Developing Countries. Clin Infect Dis