My questions:
1) How much did it cost to develop?
2) How big is the potential market?
3) How much money will it save society overall for each person cured?
There are a couple of things to consider about this. The first is that there are a lot of HCV treatments expected to come online over the next few years, so Gilead has an incentive to jack up the price now while they're the only game in town -- and with $11b in acquisition costs, they need to make their nut back on this.
Second, only a very small number of HCV patients are in high-income countries. 6.4% of all HCV victims are in US, EU and Japan, but Egypt alone has up to three times as many HCV patients as the US. (Anyone wanting to go to Egypt for cheap HCV therapy might think twice; poor infection control practices in Egypt's health care system has been implicated as the primary source of HCV infection.)
With HCV raging through so many poor countries, it's reasonable to at least discuss subsidizing global access to medications by increasing the rate paid for treatment courses in wealthy countries. The alternative would be direct financial support of global access which, given the current political climate in developed nations, is unlikely to get much traction.
I'm certainly not saying that Gilead is operating with humanity's best interests in mind -- few industries are as brutally venal as pharm -- but it seems to me that the tradeoff is something that is at least worth discussing.
I know of one drug that was running 5 figures a day in clinical trial costs. You need to charge to pay for the drug.
However, drug companies spend more on advertising than research which should give you some ideas for savings.
Right. Because all they have to do is offer the drug in an app store and the world will beat a path to their door.
I grew up in a medical household, you wouldn't believe the shit these companies do to curry favor. Some of it has been limited but much of it still continues.
There are lots of things that should be in the public sector, but "it's too important" is a bad criteria to use. Because then all the money will be in doing things that are unimportant.
People argue against creating a profit motive
by saying "it's medicine, not a trivial app,"
There are literally two countries in the world that permit direct-to-consumer advertising. It is strictly and explicitly banned by the European Union. Somehow I don't think it's harmed the profit motive at Bayer, Roche (who were profitable enough to buy one of the most profitable US pharmaceutical companies), GSK, Novartis, Sanofi, etc. etc.
The point isn't that drug companies shouldn't make money, they clearly should. At one point, 97% of the people on earth receiving treatment for AIDS were taking drugs developed by the Chief Scientist that also developed this Hepatitis breakthrough. He deserves to be a billionaire dozens of times over. The point is that it's disingenuous to try to justify the high costs to consumers by blaming R&D spending when the R&D budgets are smaller than their advertising budgets.
Pharma advertising is indefensible in nearly all cases. We have actual scientific and cost data that shows, for instance, that before Lipitor was generic, Crestor was more effective at treating high LDLs for a lower cost.[2] No amount of Pfizer sponsorship will change this fact. Allowing them to blanket the air waves and bribe doctors to get Lipitor on the formulary instead of Crestor is an ethical failing we are all responsible for. If Pfizer wants to change people's minds about Lipitor, their advertising should take the form of a sponsored independent study that shows better outcomes for patients on Lipitor. Or they could compete on price. This is how a sensible pharma market would operate.
[1] - http://europa.eu/legislation_summaries/other/l21143_en.htm [2] - http://www.ncbi.nlm.nih.gov/pubmed/18489494
There is only one country in the world where the advertising of prescription medicine to the layperson is allowed. Can you name it?
For bonus points, can you name why?
In amongst all the specific ads (which actually, to my mind, are not necessarily a bad thing - think of the 'is drug X not helping with your condition? Recent studies have shown that adding drug B to your existing regime may improve efficiency'), you get oh-so-generic ads. "Feeling 'low energy'? X may be able to help. Ask your doctor if X is right for you!"
These days, you can largely assume that most conditions are manageable, if not treatable and that your quality of life should be the driver, not advertising incentivizing you to go to the doctor (and giving you a helpful laundry list of other symptoms that you may or may not have to "aid" the "diagnosis" most convenient to the manufacturer).
Notice there aren't any commercials for stuff like antibiotics. People are already going to a doctor when they have an infection and other serious conditions. They advertise the stuff that needs advertisement. If it didn't work they wouldn't do it.
It's important to note the second type is far more common and far more expensive than the first.
That is an absolutely incredible number when you consider the best selling drug ever, Lipitor, had total sales of $11B in it's peak year.
You are correct that the patient population will continue to shrink as people are cured, but to give you an idea of the size of the market, if everyone in the US with HCV were treated with this drug this year, it would cost $3 trillion dollars.
Total Lipitor revenues over it's entire lifecycle amounted to a little over $100 billion.