Why is the price of Harvoni more than $80,000 in the USA while Harvoni from India is priced at $750 including delivery? Harvoni from India may be a much cheaper way to cure your Hepatitis C infection
Since its release in 2015, the Harvoni price has slowly dropped from its highest level of US$84,000 for a 12-week treatment, down to around US$54,000 in 2022. Despite this drop, Harvoni’s high price still makes it one of the most expensive drugs on the planet.
For people infected with Hepatitis C the high Harvoni price is the primary obstacle to being cured. Harvoni gives a cure rate of above 97% for Hepatitis C genotypes 1 and 4, however, the expensive price of Harvoni has made access to Hep C treatment difficult or impossible for many people. And even though GILEAD manufactures and markets lower-priced generic versions of Harvoni in the USA, which are available from pharmacies in the USA the price is still above US$33,000 for a 12 week treatment.
Despite the fact that the cost of manufacturing Harvoni is less than one dollar per pill, a 12-week treatment of Harvoni sells for US$84,000 in the USA, that’s US$1,000 per pill. Yet in many countries outside the USA, the retail price of a 12-week treatment with Harvoni will be between US$500 and US$1,000 depending on the country and supplier.
Apart from making a low-cost version of Harvoni for sale in the USA Gilead has also licensed the manufacture of cheaper versions of Harvoni to various pharmaceutical companies in India. The price of Harvoni in India is US$750 for a 12-week of treatment, even though it is an exact replica of the brand Harvoni made for the USA and Europe, except for the color of the pill and the price. For information about Harvoni from India click here to EMAIL ME
Recently I was involved in detailed discussions with a manufacturer of Harvoni in India. As part of this discussion, we talked about the need to make the price of Hepatitis C medication as affordable as possible so that everyone, from any country, could afford to treat their Hep C. This led to this manufacturer agreeing that they would try to produce and sell Sofosbuvir-based treatments, such as Harvoni and Epclusa, for the lowest possible price. Of course, they would still make a fair profit on the medications they made but they would make a price that gave them a profit and made the treatment affordable to everyone.
As we worked forward on this basis one very interesting fact about Hepatitis C treatment costs soon emerged, the actual cost of making Harvoni and Epclusa was a price so low that I was totally astounded. But I will get to the exact figure at the end of this article.
The issue of the expensive Harvoni price is the most controversial component of what is otherwise a miraculous medication. If it was not for the outrageous price of Harvoni people would be hailing Harvoni as the wonder drug of the 21st century and praising Gilead, its creator. However because of Gilead’s policy of making the Harvoni price so high the drug is seen as one of the worst examples of price gouging in the history of the pharmaceutical industry and Gilead as one of the most greedy and ruthless pharmaceutical companies on Earth. Adding to the confusion about Harvoni’s price is the availability of the lower-cost versions of Harvoni from India, Bangladesh, and Egypt, all of which have price tags around US$1,000 or less for 12 weeks of treatment. Given that the Indian versions of Harvoni are chemically identical to Gilead’s expensive brand Harvoni it shows that Harvoni can be manufactured and sold for a profit at a fraction of the price being charged to people in the USA who need Hep C treatment.
So how did Gilead arrive at the Harvoni price of more than US$80,000 for 12 weeks of treatment of 84 little pills. What is the actual cost of making Harvoni?
Harvoni is a combination of two medications Sofosbuvir 400 mg + Ledipasvir 90 mg and was approved for medical use by the FDA in the United States in 2014. Harvoni came on the back of the success of GILEAD’s first DAA called Sovaldi, which was a single pill of Sofosbuvir 400 mg. It was found that by combining Ledipasvir with Sofosbuvir a powerful medication was created that would treat Hepatitis C genotype 1.
Harvoni is only the optimum treatment for Hepatitis C genotype 1 and genotype 4. If you do not know your Hep C genotype you should use a pan-genotype treatment such as Epclusa or the combination of Sofosbuvir + Daclatasvir
As a result of Harvoni’s success, it is now on the World Health Organization’s List of Essential Medicines, the most effective and safe medicines needed in a health system. Unfortunately, Harvoni’s price puts this important Hepatitis C treatment out of reach of most people and even out of the reach of most national health services and health insurance companies.
In 2014, the United States Senate Committee on Finance investigated Gilead’s high price of Sofosbuvir ($1,000 per pill; $84,000 for the full 12-week regimen). Senators questioned the extent to which the market was operating “efficiently and rationally”, and committee chairman Ron Wyden and ranking minority member Chuck Grassley wrote to CEO John C. Martin asking Gilead to justify the price of its Hepatitis C medication. What Gilead replied I do not know but we do need to ask how did Gilead arrive at this price for its Hepatitis C medication?
Exactly how GILEAD arrived at the Harvoni price is clouded in secrecy however because of my contacts in the pharmaceutical industry I heard this story, which I believe is true.
When Gilead was certain that it had a cure for Hepatitis C it surveyed a number of USA based health insurance companies and asked how much it cost them if one of their customers caught Hepatitis C… from when they first contracted the disease until they died. It turned out that the cost was about US$200,000 per patient. So Gilead said something like ” so if we could cure 95% of your customers who have Hep C and charged about $80,000 per treatment that would be a price you would pay?”
So the story goes that Gilead worked out the cost of a person having Hep C to a health insurance company and then figured out what the maximum price they would be able to charge for Harvoni would be. The same logic applies to national health services in countries that offer health coverage for their citizens.
So the price of Harvoni has nothing to do with research costs because Gilead purchased the technology for Harvoni. The price of Harvoni has nothing to do with manufacturing costs, because it actually costs very little indeed to manufacture a 12-week treatment of Harvoni. The Harvoni price has to do with greed… pure and simple corporate greed.
So as these talks I was having with this Indian pharmaceutical manufacturer progressed we came to the point where the final wholesale prices and the actual manufacturing costs were discussed. To my amazement, the cost of manufacturing a 12-week treatment of Harvoni in India, a product absolutely identical to Harvoni, including all the packaging, the bottle, the box, etc was less than US$150. That is approximately US$50 per bottle!
Now, this is the cost for a manufacturer to actually make 84 Harvoni pills and put them into bottles and so on. Obviously, there are many other costs and overheads, including royalties paid to Gilead Sciences. But all this means is that a 12 weeks treatment of Harvoni from India should cost no more than US$750 delivered.
The manufacturer I have been talking to is a relatively small-scale operation compared to Gilead. When Gilead does a production “run” they probably make at least 10 million Harvoni pills at a time. So based on the economies of scale I would guess that Gilead’s cost per 12-week treatment is much less than $150 per treatment.
Many people will say: “Oh yes but Gilead is manufacturing Harvoni in the U.S.A. where manufacturing costs are higher.”
Not true! Gilead has the active ingredients of Harvoni and Epclusa manufactured in the Middle East country of Jordon. So the active ingredients for Gilead’s Hepatitis C medications are made in a middle eastern country. Then they are shipped to Ireland where the active pharmaceutical ingredients (APIs) are mixed with inert powders and turned into pills. After being turned into pills the packaging also happens in Ireland because Ireland is a low taxation zone which allows Gilead to avoid paying taxes in the USA.
So have a little think about this situation. Gilead has a stable of medications, Sovaldi, Harvoni and Epclusa which could save the lives of nearly one million people each year, not to mention the suffering of the more than 100 million people infected with Hepatitis C. This treatment costs less than $50 to make. Gilead avoids US taxes by having its packaging done in Ireland and its pharmaceuticals manufactured in Jordon.
Gilead’s retail price for 12 weeks of Harvoni or Epclusa is around US$84,000, whilst their cost is less than US$200. So they are multiplying the cost of manufacture of Harvoni and Epclusa by around four hundred times to arrive at the retail price. I would be so bold as to suggest that in the entire history of the human race there has never been a product sold with such a massive profit. Such an obscene profit.
So when we learn that the price of making Sofosbuvir + Ledipasvir is less than one dollar per pill it is not surprising that pharmaceutical companies in India, and in other countries not covered by Gilead’s patents, decided to make and sell Harvoni for significantly less than GILEAD’s price of around US$1,000 per pill.
For example, in India, Harvoni has a price of less than $10 per pill with a standard 12 weeks treatment with Harvoni from India costing around US$700. Its important to remember that Indian Harvoni is identical to Harvoni in the USA because production of Harvoni in India is regulated by licensing agreements and the sharing of intellectual property involved in the manufacturing process.
In other countries, where licensing has not happened because Gilead does not have patents, such as Egypt or Bangladesh, a 12 weeks treatment with Sofosbuvir+ Ledipasvir costs even less, at around US$500 for a 12 weeks treatment. However in these countries there are issues of quality. Because in Egypt and other places the manufacture of Harvoni is not licensed we can not be certain that the formula of these versions of Harvoni is the same as Gilead’s Harvoni.
If you want to purchase Harvoni for US$750 for 12 weeks treatment I can organize everything for you.
The maximum price for a 12 week treatment of Harvoni is US$750. Email me now for details using the contact form at the bottom of this page.
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