WASHINGTON – Alvin Teasly, 60, wore many hats. He was a school bus driver, licensed mechanic, typist, handyman, construction worker and finally a school bus driver again.
He lived his modest life in Prince Georges County, Md., with family, friends and his personal faith.
In 2013, he was diagnosed with heart failure and diabetes, which forced him to retire early. The tests also found he had hepatitis C.
Once he heard how expensive the best treatment for the disease was, he lost hope.
“Between all the treatments I was having, I wasn’t sure if I was gonna be around,” he said.
His doctor prescribed Harvoni, a 12-week treatment with few side effects, which is sold by Gilead Sciences Inc. It has a 90 percent cure rate. But it costs $94,000 without insurance. Sovaldi, Gilead’s previous hepatitis C medicine, costs about $84,000.
Teasley began to believe he was worth it when doctors told him his insurance would finance the treatment.
“When they say were going to finance that expensive treatment,” he said, “then I’m saying, ‘Well, I get I’m not going away soon,’ and yeah, that restored my faith in living.”
That’s not always the case, however.
Without government regulations on pricing, pharmaceutical companies have little to no competition to bring prices down. The Senate Finance Committee released a report Dec. 1 that said Gilead’s plan for the drug was to maximize profits. Gilead released a statement disagreeing with the report.
“Gilead pursued a calculated scheme for pricing and marketing its hepatitis C drug based on one primary goal, maximizing revenue, regardless of the human consequences,” Sen. Ron Wyden, D-Ore., said at a Dec. 1 press conference.
Hepatitis C is a disease in the blood that has a 60 percent rate of damaging the liver if left untreated. Previous medicines required longer treatment times and had harsher side effects.
Dr. Linda Green, a retired physician from Prince George’s county, said the relief one of her patients had the day she found out about her cure was a stark contrast to when the patient first learned she had Hepatitis C.
Over 600,000 patients were treated with the Gilead’s drug in 2013, according to the company’s statement. The statement also said the company priced the drug “in line with previous standards of care.”
A 2014 study conducted by the University of Liverpool found that the total production costs of Sovaldi would range from $68 to $136 for the entire treatment.
Gilead has programs that help underinsured patients acquire the medicine, but the process can be complicated and tiring.
Teasly said he was able to afford treatment because he had a case worker who helped him navigate the system and was able to get Medicaid to pay for it.
While some Medicare programs and the Department of Veterans Affairs are able to negotiate drug prices, the report outlined that the cost of the drug still places a strain on programs, causing them to restrict the number of patients they treat. Medicare has different criteria in each state for accepting patients for the treatment.
MaryAnne Lindeblad, Medicaid director of Washington state, said in a letter attached to the report that her state had between 75,000 and 85,000 hepatitis C patients.
“States may be forced to make difficult choices related to coverage for other Medicaid services in order to afford these new and very expensive drugs,” she said.
Medicaid is not able to negotiate drug prices with companies. Medicaid is a joint federal and state program that assists low-income individuals with health care. These programs also try to save costs by making it more difficult for patients to receive treatment, such as having a higher state of liver disease. The report said that Medicaid treated only 2.4 percent of patients who had Hepatitis C.
The report said that the U.S. spent $7.8 billion in 2014 for Sovaldi. That totaled more than what was spent from 2010 to 2013 on hepatitis C medicine.
Over 3 million people have been diagnosed with hepatitis C, though the number may be underestimated because of the common symptoms, according to the Center for Disease Control. Symptoms include pain in the abdomen, nausea, fatigue and fever.
Teasly said he felt fortunate he was able to have his treatment paid for. He now has the energy to cook for himself and walk.
“It’s like they had my life in their hands,” he said. “You think nobody cares about you, you ain’t got no money, you’re nothing, but … they tell you they’re going to cover it, I feel like something,” he said.
Reach reporter Jessica Pereda at [email protected] or 202-408-1493. SHFWire stories are free to any news organization that gives the reporter a byline and credits the SHFWire. Like the Scripps Howard Foundation Wire interns on Facebook and follow us on Twitter and Instagram.
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