This is the first of a two part series.
The post below is something I have been meaning to complete for nearly 8 weeks now. I started writing it immediately after leaving Paris where I attended the 2018 EASL Conference. I guess I have been putting off writing this because it is a subject that fills me with disgust when I think about it.
I feel disgust because there are so many supposedly respectable people with their snouts in the Big Pharma money trough. People who are being paid to look after the best interests of their patients or the citizens of their countries. High ranking health bureaucrats, leading doctors in research hospitals, supposed health advocates and the rest of the rabble of self-interested, money driven hypocrites.
Harsh words, strong emotions… these are the reasons I have delayed completing this post. But today I received an email from a pensioner in the USA followed by a comment from a Hep C advocate in the U.K. These two things finally motivated me to complete this post. Let me share these two communications before you read the completed post:
Sent: Thursday, 5 July 2018 3:20 AM
Subject: Hepatitis C Treatment “Thank you for your article”
Subject: Thank you for your article
I recently received word that Medicare would fund my Hepatitis C treatment, however when I noticed the actual price tag on my Harvoni I was so incensed that it’s cost is a small fortune, as I am a senior citizen on a fixed income, the cost was astounding.
Particularly knowing that my Medicare part D is footing the bill of Gilead’s greedy capitalistic endeavour, it sure makes me wish the government was more interested in consumer protection as they would be the only ones powerful enough to do something to stop this price gouging. Instead of doing something to improve things they just bemoan the cost of caring for vulnerable populations. Thank u for your clarity on this issue, your work is valuable.
Greg, last week in the UK it was announced that 17 procedures that are normally offered by the National Health Service would now only be available in “exceptional circumstances” . These include treating Carpel Tunnel syndrome and steroid injections for back problems. The harsh reality is that the drop in the value of the pound has combined with the insane prices that the NHS is paying Big Pharma for medication to almost bankrupt the NHS. When is someone going to do something? When is it going to change?
The reality is that Big Pharma plays the system, using its vast, almost incomprehensible, wealth to bribe, buy, influence and otherwise own the influential people within the health professions across the world.
Big Pharma buys health bureaucrats, doctors and professors from leading medical universities and also owns, or controls by proxy, most of the Hepatitis C advocacy groups.
In terms of Hepatitis C Big Pharma is the sole funder of the World Hepatitis Alliance and provides around 50% of funding for almost every other Hep C advocacy groups in the world.
If you do not believe me on this please look that the annual reports of any Hepatitis advocacy group. In the USA this can be found in their 990 form.
So to get back to EASL 2018 and the most foul example of just how Big Pharma shapes and controls global health policy.
EASL stands for European Association for Study of the Liver but the conference is also known as the ILC, International Liver Conference.
EASL is the premier international liver event. It is sponsored by Big Pharma in a BIG way. Big Pharma pays the frontline speakers. Flies them in from all around the world, business class of course.
Big Pharma puts these people up in classy hotels and pays their bill.
On top of all these lovely little perks these speakers are generally paid tens of thousands of dollars to speak on particular subjects. For this package of money, air fares and hotels these scientists and academics often only need to speak for 15 or 20 minutes.
Of course, there is a condition to getting onto this gravy train, the speakers are expected to say what Big Pharma wants to hear and not to mention anything that Big Pharma does not want discussed. For their thirty pieces of silver these doctors and professors must betray their academic and scientific values. They must sell their integrity and independence to Big Pharma.
A fine example of how readily scientists and medical professionals are will to prostitute themselves was at Gilead’s EASL symposium called “Shaping Tomorrow Together.”
Shaping Tomorrow Together was the biggest event that I attended at EASL… to get the number of attendees up Gilead put on the fine food in a big way.
When I arrived at the venue I saw an endless river of waiters flowing through the crowd carrying platter after platter of exotic and tasty hor d’oeuvres, too many to name and many I could not name. Pastries, smoked meats, delicacies skewed by little sticks or rolled into tubes or piled on top of little squares of toast. I would guess the nibbles would have cost around $20,000 to feed the hundreds of medicos who had gathered for the feed: everyone loves a free feed and this free feed was the best.
Hundreds of doctors, gastroenterologists and hepatologists, as well as their assistants, students and wives hooked into the free food. I guess there were five or six hundred of the world’s liver elite munching away.
After 30 or 40 minutes the flow of food slowed then stopped. When the food stopped the flock of Doctors and others were gently herded into the auditorium where a panel of illustrious liver experts, handpicked and paid by Gilead, sat on the stage, under floodlights, waiting to deliver their vision of the future.
A future free of Hepatitis C. The tomorrow that Gilead would shape.
On the stage were a mixture of leading acaemics and health bureaucrats including:
Professor Victor de Ledinghen, the secretary general of the French Association for the Study of Liver Diseases.
Professor Stephan Zeuzem Chief of the Department of Medicine at the Goethe University Hospital in Germany
Dr Brian Conway from Canada’s Vancouver Infectious Diseases Centre
Michael Ninburg Executive Director of Hepatitis Education Project and President elect of the World Hepatitis Alliance.
As well as many other dignitaries and notables from the world of Hepatitis.
But I would like to focus just for a moment on Michael Ninburg who is the current head of the World Hepatitis Alliance and previously ran the the Seattle-based Hepatitis Education Project. Public records show the Hepatitis Education Project receives as much as 50 percent of its funding from pharmaceutical companies including Gilead. Several of the Hepatitis Education Project’s medical advisers and at least one board member also receive money from pharmaceutical companies including Gilead.
Now Ninburg is running the World Hepatitis Alliance, unlike his previous organisation the WHA receives 100% of its funding from Big Pharma.
So who is Ninburgh advocating for? Is it the people of the world infected by Hepatitis C or is he advocating for Big Pharma?
So when Ninburgh stood up to speak I stood at the back of the crowded hall, leaning against the wall, watching and listening.
The theme of Ninburgh’s talk and then of Prof. de Ledinghen’s talk, and all the other talks was basically about the barriers that stop people getting access to treatment.
I listened to each speaker stand and talk and as I listened my anger and frustration grew because not once did any speaker mention the price of the medication being a barrier to accessing treatment.
They talked about education.
They talked about antibody testing.
They talked about blah, blah this and blah, blah that… but no-one mentioned the bleedingly obvious fact that it is the EXTREME cost of Hepatitis C medication that prevents most people from accessing treatment. Any one who pretends otherwise, or who ignores this fact is either a fool or in the pocket of Big Pharma.
Well I was standing there and my blood pressure was rising and I was fighting down the urge to scream out “ What about the price?” I came so close to screaming it out but i fought it down as I did not want to be thrown out of EASL and banned from returning because I had work to do there in the morning. So instead I walked out of the hall and paced up and down until I had calmed down enough to return.
Once back inside I listened to a French man, I think it was Prof Ledinghen talking about the massive Hep C antibody testing program that the French government was planning to launch. This would bring in all the people infected with Hepatitis C in France and the goal was to get everyone treated within two years.
A fantastic goal but let us think about this.
We are in a forum paid for by Gilead, with speakers paid for by Gilead. The speakers are all pushing for accelerated Hep C testing and treatment… Why are they pushing this? Why does Gilead want accelerated HCV testing in countries like France, Germany, Canada and Italy?
The reason is simple, in countries like France and Germany and Italy and Holland the Hep C treatment is paid for by their National Health services. Gilead knows that the prices of Hepatitis C medications are falling rapidly. These countries are all locked in with Gilead for the purchase of Harvoni, or Epclusa at fixed prices; high prices.
Gilead wants accelerated testing and treatment so that most of the people with Hep C in France, Canada and Germany and so on will get treated BEFORE the price of Hep C medication drops to a level where the profits are not so extraordinary as they are now.
Remember that a 12 week treatment of Harvoni or Epclusa costs Gilead about $40 to make, about 50 cents a pill. So even when they are selling to National Health Services for between $10,000 and $20,000 they are still making extraordinary profits.
Gilead is not interested in providing treatment to people in poor countries, only the wealthy countries. Gilead is focused on putting pressure on the health services of wealthy countries that provide free health services to their citizens and who will buy bulk quantities of Gilead’s DAAs at the still hugely inflated prices around today.
So Gilead invests in the health bureaucrats, professors, doctors and advocates to make sure they can treat as many people in the wealthy countries as quickly as they can. Big Pharma applies pressure on governments from every possible angle, through Hepatitis C advocacy groups that it funds, through doctors that it bribes with free trips or lavishly paid speaking engagements and so on.
In the meantime, when governments divert billions of health dollars to funding of Hepatitis C treatment programs other areas of health suffer. This money goes on paying the insane prices of Big Pharma’s drugs when cheap and effective alternatives are readily available.
For example in the UK and in Italy the health budget is stretched to breaking point and yet these countries are spending hundreds of millions of dollars on expensive Hep C treatments when their patients could be accessing the same medication at fraction of the price, a hundredth of the price, thereby freeing up funds for other areas such as Maternity or Emergency.
But there is no money for Big Pharma in maternity or Emergency so they do not host expensive conferences or bribe doctors and advocacy groups to pressure governments to spend more money on Maternity or Emergency.
Big Pharma uses its incredibly vast wealth to buy influence only in the places where it can make the maximum profits. Big Pharma does not care about health, it does not care about patients, Big Pharma only cares about profits… nothing else.
So what “tomorrow” is Gilead trying to shape for us?
Firstly let us be clear that Gilead is not interested in a Hepatitis C free world. Gilead is interested only in maximising profits.
To maximise profits Gilead will use all its power and money to influence the decisions of policy makers around the world to ensure that Gilead sells as much Hep C medication as it can at the maximum profit possible. In the process it will infiltrate and corrupt organisations and people. It will infiltrate government health departments, university hospital and advocacy groups. It will gain the loyalty of people through gifts, “donations”, free lunches, free travel, fancy accommodation and payments for speaking at conferences.
Where once medicine was about bringing health benefits to populations, about healing people, it is now more and more simply another way that large multi-national corporations can maximise their profit margins at the expense of the tax payers of the world.
The public health budget of every nation, rich or poor, is a pie of a limited size and almost always not big enough. When a big slice of the health budget pie is given to paying for Hepatitis C medication, at 100 times the real world price of that medication, then all other areas of that nation’s health suffers.
If health professionals and Hep C advocacy groups genuinely wanted the best outcome for people with Hepatitis C and for their society as a whole then they would be pushing their governments to make generic Hepatitis C treatments easily accessible to their citizens. This would then put real pressure on Gilead and other Big Pharma companies to reduce their prices to be compeditive with generic Hep C medication. This would make a real difference, this would result in a Hepatitis free world.
But that is NOT the future that Gilead wants to shape.
For further information on how Big Pharma buys influence within Hepatitis C advocacy groups please use this link
Other US bases Hep C groups:
National Viral Hepatitis Roundtable. Gilead and its foundation donated $140,000 in 2015, covering about 22 percent of its budget.
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