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We recently praised the Bristol-Myers Squibb (BMS) marketing of daclatasvir as a ‘stand-alone’ hepatitis C drug which could be easily marketed and combined with other drugs instead of being packaged only with other drugs from the same company in a proprietary “package” (http://hepcbc.bchep.org/2014/10/praise-stand-alone-hcv-drugs/). When our goal is the eradication of hepatitis C worldwide, we want to get the best drug(s) out to the greatest number of people, worldwide, as soon as possible. This means drugs are accessible and affordable even in the least developed countries, and can be combined in customized “cocktails” with other companies’ drugs according to the latest research results, availability, and patient needs (particularly genotype). BMS’ policy, which gives all stakeholders greater flexibility in both clinical and financial terms, is being actively promoted by BMS in a new policy paper in which they say:
“Bristol-Myers Squibb recognizes the significant public health challenge that hepatitis C (HCV) presents worldwide, including the substantial burden of the disease in the developing world. With more than 80% of the global HCV patient population living in low- and middle-income countries, there is great need for hepatitis C treatment options in these countries. The significant challenges facing many of these countries are not homogeneous, in particular the need for governments, non-governmental organizations, civil society and industry to form coalitions.
As part of our Company-wide commitment to increasing access to medicines for patient populations in need, we have initiated discussions with government health authorities and other stakeholders in a number of developing countries to facilitate access to daclatasvir. Bristol-Myers Squibb’s HCV developing world access approach will utilize tiered pricing, licensing agreements and working in collaboration with other stakeholders who share in our commitment to working toward the eradication of hepatitis C.” (source: http://www.bms.com/responsibility/access-to-medicines/Pages/HCV-developing-world-strategy.aspx)
This company seems to be on the right track. Like Gilead Sciences, which has been playing catch-up in the public relations sphere after its stumbles with the marketing of HCV drug sofosbuvir (www.gilead.com/~/media/Files/pdfs/other/Intellectual%20Property%20and%20Patient%20Access101014.pdf), BMS is focusing on pricing and production in the lower (and lower-middle) income countries now. However, until patients in middle income countries such as Brazil or those of eastern Europe – and even the poor living in higher-income countries such as Canada – are able to access (afford) these medications, we will not see hepatitis C eradicated anytime soon. Right now the pricing in the higher-income countries, in particular, seems not to be based on an “economies of scale” model in which profits are made by lowering prices in order to expand the quantity of purchases. We believe this is the course that will eventually be recognized as not only the most moral, but the most profitable for all stakeholders including the pharmaceutical companies.