PESHAWAR: As the federal government is likely to register Sovaldi (Sofosbuvir), the first oral drug for hepatitis C patients in the country, for sale, experts stress the costly drug’s price should be fixed keeping in view the people’s poor purchasing power.

Sovaldi, whose developer, Gilead, an American pharmaceutical company, is expected to earn $9.1 billion by 2017, was recently registered by the US Food and Drug Administration.

However, it has yet to be registered in Pakistan. Currently, it is imported in the country on patient-to-patient basis for slightly more than Rs300,000 for six months, the price beyond the reach of the majority of local patients.

Local experts told Dawn on Thursday that the government should consider the total cost of the hepatitis C treatment and the purchasing power of local patients before registering the drug.

“It remains to be seen how Pakistani registration authorities negotiate the price of Sovaldi for patient of chronic hepatitis C in Pakistan, many of whom cannot even afford the current much lower cost of their treatment. Our experience about the drug registration and price fixing is not very pleasant but let’s hope this time around it is different and good,” said Professor Najibul Haq of the Peshawar Medical College.

Professor Najib said the current six months cost of the conventional interferon treatment was around Rs25,000, while for pegylated interferon, it varied from Rs70,000 to Rs150,000 depending on the pharmaceutical company.

He said its safety and efficacy had been well established and it was highly effective oral drug used for treatment of all types’ hepatitis C infection, including genotypes 1, 2, 3 and 4.

The expert said the recommended duration of treatment for genotype 2 and 3 hepatitis C, the commonest in Pakistan, was 12 and 24 weeks respectively.

“It is given in combination with another cheap oral anti-viral drug, Ribavarin, which is freely available in Pakistan,” he said.

According to Professor Najib, the cost of Sovadi is $1,000 per tablet in the US and that the high price forced local insurance companies to have reservations about its coverage in the health insurance schemes and thus, restricting its prescription.

“Unfortunately, the laws of the potency of products have made it possible for a pharmaceutical company to fix the price of a new patient on its own choice, even without human consideration,” he said.

The expert said the system of registration of drugs in the most developing countries, including Pakistan, had many loopholes, which were exploited to benefit the relevant authorities in the form of kickbacks for higher registration price of drugs at the expense of patients.

He said the Sovaldi price in India had been negotiated to around $11 a pill ($2000 for six months) but it could be brought to around $1500.

“In Egypt, the drug’s price has been negotiated at $10 a tablet,” he said.

Professor Najib said the ‘profit-driven attitude’ of the pharmaceutical companies often resulted in repeated shortage of life saving drugs in Pakistan due to low returns.

He said the pharmaceutical companies were aware of the poor and rather no accountability which they could face over unavailability of life-saving drugs and that they almost always got away with such situations.

Published in Dawn, June 13th, 2014