Direct-acting antivirals, or DAAs, are a type of drug that attack proteins in viruses and messes up their replication, causing them to die out -- like a microscopic Children Of Men. Since 2014, there's been a DAA that has over a 90 percent cure rate for hepatitis C, the chronic blood infection that hits the liver and is the scourge of healthcare workers, the exuberantly frisky, and legendary baseball players. If 260,000 sufferers in the U.S. were to undergo the DAA regimen every year, the country would be Hep-C-free by 2030. It's such a great idea that even the slogan writes itself. But the healthcare industry would disagree on that.
Despite vocal outrage by medical professionals and even successful class-action lawsuits against insurers, most hepatitis C sufferers aren't getting the DAA cure. Private insurers flat out deny over half of DAA prescriptions, with patients on Medicare and Medicaid faring somewhat better. Worse, the number of denials seems to be rising. The insurers' reasoning for denial is simple: With a cure that costs up to $100,000, it's just too expensive to give to everyone. So they tend to only grant it to those on the brink of death. So somehow, most people with hepatitis C aren't eligible for the cure for hepatitis C. That sounds less like a real-life situation than a quote from a Catch-22 sequel called You Catch It, You Keep It.
But why does Big Pharma make such an important cure so expensive in the first place? Depressingly, it all comes down to basic supply and demand. Don't take our word for it, but that of a Goldman Sachs analyst. In a report titled "The Genome Revolution," she posited that it's just bad business to actually cure people of what ails them, and she even used the DAA treatment for hepatitis C as a model. When the cure first came out, Big Pharma was able to sell $12.5 billion worth of it. But then the pesky thing started reducing their customer base (i.e. healing them), and now their profits have gone down to a paltry $4 billion. If that downward trend holds, soon they'll actually run out of hepatitis C to cure! If you can't turn saving lives into a sustainable business model, why even bother?
That's some ruthless math right there -- about as ruthless as, say, maybe figuring out which percentage of patients you should hypothetically deny a cure to so that their highly infectious disease never runs the risk of being wiped out and your expensive cure can remain profitable. Not that we'd ever accuse the same industry that performs illegal experiments, bribes doctors to get them to dangerously over-prescribe, and makes billions off cures for drugs they created. That would be very unlike them indeed.
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