This column, an occasional feature, was originally published on Reuters.com.
1. An Eric Cantor sweepstakes:
Who’s going to hire the soon-to-be unemployed but highly marketable Representative Eric Cantor (R-VA)?
He’s got a law degree, a world-class Washington Rolodex and the kind of visibility that should make him a client magnet for K Street’s law firms and lobbying and public policy shops.
Or will he go to a think tank? That path might be more complicated because the most likely home for a conservative heavyweight, the Heritage Foundation, seems to have veered so far right that it might be awkward to welcome a guy just beaten by a candidate who attacked him from the right.
Or will he go home to Richmond, a place he might not now have to go home to had he spent more time there before the primary?
It’s not too early for a reporter to start tracking Cantor’s job hunt.
2. Drugs that save lives and annihilate budgets:
“‘This is the tip of the iceberg,’ said Steven Pearson, president of the nonprofit Institute for Clinical and Economic Review, which analyzes the effectiveness of new treatments. ‘We have about a year or two as a country to sort this out before more specialty drugs hit the market.’ “
Pearson’s quote appeared in an article from Kaiser Health News last month. It was about a wonder drug called Sovaldi, which apparently cures 90 percent of patients who have potentially deadly hepatitis C.
The cure simply requires taking one pill a day for 12 weeks. There appear to be few or no side effects.
Lots has been written lately about Sovaldi and Gilead Sciences, the company that makes it. Gilead is charging $1,000 a pill, meaning the full, 12-week treatment costs $84,000.
Sarah Kliff, the former star Washington Post Wonkblog healthcare reporter who has moved on to Vox, calculated, “California … might have to spend more on buying Sovaldi for its Medicaid beneficiaries than it currently does on all K-12 and higher education.”
Or as the Kaiser Health News article pointed out, if every hepatitis C patient took the drug, the country would spend $300 billion on it — doubling the country’s current bill for all prescription drugs.
As the clamor over Sovaldi has continued, Congress has threatened to intervene, somehow, to make Gilead charge less. America’s Health Insurance Companies, the industry trade association, has issued an almost-daily volley of press releases and speeches using Sovaldi and Gilead as the poster boys for drug-industry abuses that will bankrupt the country.
Yet for all that attention, Pearson was right when he told Kaiser Health News that this is the “tip of the iceberg.” Sovaldi and Gilead require multiple doses of much more in-depth reporting.
For starters, can some reporter please take us into the meeting where the Gilead executives decided to charge a flat $1,000 per pill?
I’m not referring to the high price and humongous profit margin it yields. (Now that the expensive research to develop Sovaldi is over, each pill probably costs Gilead a dime to 20 cents to make and package.)
What I’m curious about first is why the folks at Gilead didn’t feel enough of a sense of accountability or sensitivity to public reaction to decide to charge, say, $989 or $1,023. That would have at least given the impression that in calculating the price they did something other than ask “Why not?”
Who are these people who are so clueless or arrogant that they seem to have picked a nice, fat round number with all the care of choosing a bagel? Only a Sovaldi spokesperson has been accessible to the press — and usually with prepared statements. Who’s going to be the first reporter to put a microphone in front of Chairman John Martin?
First questions for Martin, whom, Bloomberg reported in March, has become a billionaire because of the Sovaldi affect on his company’s stock since the drug was approved last December: Why not $2,000 a pill? Or $5,000? Should there be regulations that would stop a company from charging any price, no matter how high?
Then there’s Gilead’s argument that Sovaldi is worth the price because it allows patients to forego years of expensive care that would otherwise be necessary to control their illness. Has anyone done that math? And because Sovaldi is a new drug, how can we know its treatment will last patients a lifetime?
Speaking of math, there’s the question of whether the research and development costs that went into creating Sovaldi justify the price. Conversely, would putting a cap on the price Gilead could charge kill off the investment that produces these kinds of breakthroughs?