In 2014, a wave of enthusiasm swept the medical field as new medicines to cure hepatitis C became available. Older treatments had limited success in eradicating the virus, and side effects stopped many from completing treatment. The new medications can eliminate the virus in 80 to 95 per cent of cases, are in easy-to-take pill form and have few, if any, side effects over the 8 to 24 weeks of treatment.
The wave crashed, however, on the cost of the medications: a thousand dollars per pill. Profits to Gilead Sciences, the first to get a new drug approved, are projected in the billions. In yet another chapter of the racist U.S. bosses’ history of medical apartheid, the high cost of these medications hits Black workers hardest, along with millions of workers around the world suffering from this virus.
Hep C and Racism
Hepatitis C affects from 135 to 160 million people worldwide, including an estimated three million in the United States. According to the U.S. Centers for Disease Control (CDC), Black workers comprise 22 per cent of all hepatitis C patients, despite being only thirteen percent of the U.S. population. The mortality rate for middle-aged Black workers with hep C (8 percent) is twice that of comparable white workers; native Americans and Alaskan natives with hep C have an even higher mortality rate. In the U.S., more people die from hepatitis C complications than from HIV-related illnesses! Hepatitis C causes death from liver cancer and cirrhosis of the liver in 5 to 10 per cent of sufferers, and is the leading cause of liver transplants in the U.S.
Hepatitis C is usually a chronic disease. Life-threatening complications take 10 to 30 years to develop. HIV and alcoholism increase the rate and speed of complications. While physicians agree that almost all of those infected should be treated, the insurance companies have decided that only those with the worst disease should get medication. The process to get approved for treatment under Medicaid frustrates both doctors and patients. Many give up, and the cost is prohibitive for the uninsured and undocumented. If you live in states like Louisiana, which opted out of expanding Medicaid under the Affordable Care Act, you’re similarly out of luck.
Pharmaceutical price-gouging has been in the news of late—particularly the company that raised the price of Daraprim, which treats an HIV-related illness, from $13 to $750 per pill. But Daraprim is only the best-known example. Current costs for the new hepatitis C treatments—Harvoni, Solvadi, and Veikira Pak—would bankrupt public health programs like Medicaid. Medicare faces huge costs as well, since federal rules bar Medicare from negotiating lower prices. Legislative efforts to change this policy have failed, because politicians are bought and paid for by the drug companies.
Bosses Profit, Workers Die
Pharmaceutical companies like Gilead claim that prices are driven by research costs. In fact, research on the hepatitis C virus was funded publicly, through taxes paid by the working class to fund institutions like the National Institutes of Health. Scientists and investors developed this public research, claimed the patent rights for the first drug, Solvadi, and formed a company, Pharmasett, that invested less than $500 million in research and development to produce the medication. Gilead then bought the drug for $11 billion and promptly began selling it. Production costs per patient are about $100, but the price of treatment is approximately $100,000—a markup of one thousand to one. In the first year alone, Gilead billed Medicare and Medicaid $6 billion. This naked capitalist struggle for profits leaves workers without lifesaving treatments.
International treatment of hepatitis C is likewise controlled by the drug companies. Trade agreements like the Trans-Pacific Partnership agreement are designed to protect companies’ patents. Egypt, with the highest rate of hep C in the world, was offered a discount but only for “a sliver of people abroad who are lucky recipients of some specialized access program…access is fatally compromised and the human right to health is fundamentally violated” ((Jeffrey Sachs, consultant to World Health Organization).
Smash Global Medical Apartheid!
A communist society would prioritize research, development and mass production of every life-saving treatment. Communist worker-scientists would no longer be driven by profit; medical breakthroughs would be the property of all. The communist Progressive Labor Party is fighting for that world. In Washington, DC, where the prevalence of hep C runs from 9 to 12 percent in Black working-class clinics and hospitals, PL’ers have been calling for screening and treatment. We are preparing to move to the next level with a campaign at the American Public Health Association (APHA), protests at lobbying giant PhRMA headquarters, and continued patient advocacy.
Capitalist restrictions on biological breakthroughs extend beyond hepatitis C medications. New medicines for HIV, cancer and heart disease are often price-gouged, even though government scientists did the research. We are organizing and fighting back while also showing that attempts at reforming drug pricing will never be enough. Reforms will always exclude the hundreds of millions of our working-class sisters and brothers around the world who won’t ever be able to gain access to these medicines under capitalism. Only a communist revolution will enable the working class to manage its own health care, research and pharmaceutical distribution. Only a communist world can eradicate the virus of capitalism.
