This new pill provides a moral puzzle

David MoonBlog

The Centers for Disease Control estimates there are 3.2 million Americans with chronic Hepatitis C, 17,000 of whom will die this year as a result of the infection—a number that exceeds the annual deaths from HIV/AIDS in the US.

Fortunately, Gilead Sciences produces a new breakthrough drug, Sovaldi, which has proven to cure 90 percent of all Hepatitis C patients.

The drug costs $1,000 a pill, or $90,000 for the typical three-month treatment.

The cost of 90 days of Sovaldi treatment for the estimated 12,000 infected TennCare enrollees would be one billion dollars a year. Combined with the $300 million it would cost to treat the state’s infected prison population, the government would spend $1.3 billion in Tennessee on this single drug.

TennCare’s currently most-expensive drug, the antipsychotic medication Seroquel, costs the program $32 million annually.

Outraged at the prospective cost to treat Medicare and Medicaid enrollees, U.S. Senators Ron Wyden (D-Oregon) and Chuck Grassley (R-Iowa) have requested reams of information from Gilead, reminding the company’s CEO, Dr. John Martin, that the Federal government is the health care industry’s largest customer.

Part of the problem with our health care system, of course, is that if Gilead is the seller and the government is the customer, what is the patient?

These two lifelong politicians (combined tenure in elected offices: 88 years) want to determine what the free market price of the drug ought to be and how much the company should charge in specific markets.

If the US federal government refused to pay more than $10 a pill (the price Gilead charges in low-income countries, like India) what would happen if Gilead simply rejected the offer? Would the Feds force the company to sell the drug?

Morality requires that government do whatever is necessary to protect the basic human rights of its citizens. Logic requires that if access to affordable healthcare is a right, no private entity can be allowed to hold society hostage with predatory pricing.

Is free Sovaldi a right? Is low-cost Sovaldi a right? Do low-income people have a right to the same quality and quantity of health care as do wealthy people?

Does the general wealth of our country affect the answer to those questions?

Government cannot morally limit or ration a basic human right. Rights do not exist in degrees. The partial diminution of a right is the elimination of it.

Officials in Senator Wyden’s state have recommended limiting Sovaldi to only the sickest of the state’s Medicaid patients, tacitly admitting that access to affordable healthcare—access to free Sovaldi, anyway—while certainly laudable, is not a basic human right.

The short-term solution to this specific issue is predictable. Sovaldi will lower its price in the US. The philosophical question, however, will remain: under what circumstances does the public good require partial or full government condemnation of an individual’s property?