Overpriced Amorality

The young man stood at the desk. Clean shaven, gelled hair, fitted charcoal suit, pinstriped shirt, and perfectly dimpled tie. He was holding two brown paper bags.

“I’m not selling drugs.”

He smiled.

“Just some warm paninis for the doctor and his hard-working staff.”

He reached across the desk. The receptionist hesitantly accepted.

“I have a poster and material to educate your patients about current recommendations for Hepatitis C screening.”

He was still smiling as he put a stack of folders and three poster tubes on the desk.

“And my card.”

The lettering at the top was gray. It said ‘Gilead’.

I’d like to trace a connection between an amoral society and overpriced pharmaceuticals. My contention: the fundamental problem with big pharma, with the healthcare system, with everything is me. And you. We are sinners, depraved, capable of good, in need of a Savior and internal regeneration.

Gilead Sciences is a Biotech company that purchased a smaller company named Pharmasset in 2011 for 11.2 Billion dollars (1). At stake was the molecule “7977”. It was a novel treatment for Hepatitis C. Gilead named the drug Sovaldi and released it to the market in 2012. The medication is taken once daily for twelve weeks and cures almost 95% of Hepatitis C. Truly Amazing! Gilead priced their drug at over 1,000$ per pill or about 85,000$ for the twelve weeks required to treat Hepatitis C. At the time, this was the most expensive medication in the history of the world. It has unfortunately since been surpassed by several medications.

In the first three years that Sovaldi was on the market Gilead made over 44 Billion dollars!

The young man in the anecdote above was a pharmaceutical representative, passing out trifles. The medication produced by Gilead Sciences is breathtaking in both its efficacy and pricing. Checking my patients for Hepatitis C pads their bottom line. And that’s a conundrum.

Sanofi-Aventis is a French pharmaceutical company that developed Insulin Glargine, released in 2000. Marketed as Lantus, this was the first true twenty-four hour insulin. An injection of Lantus once a day reproduced the action of basal insulin. This changed the treatment algorithm for Diabetes. Over the next decade, Lantus became the most popular type of insulin prescribed in the world.

Initially the monthly cost of Lantus was about 200$. That’s a lot, much more than the older insulins which were available in 2001 and 2002. Sanofi profited handsomely.

Every medication benefits from about ten years of patent protection. During this time, the company that brought the medication to market can set the price and produce without competition. The patent system is designed to reward creative entrepreneurs, to provide a mechanism to recoup research and development cost.

The patent on Lantus was scheduled to expire in February, 2015. Approaching that date, Sanofi implemented three corporate strategies. First, gradually increasing the price of Lantus, to extract every possible dollar of profit. This price increase occurred even as the production cost of insulin glargine decreased. In 2002 the average cost of a month of insulin was 200$. By 2013, a month of insulin averaged more than 700$ (2). If you have Diabetes, you have experienced this price increase firsthand.

The second strategy of Sanofi was to go to court in early 2014 and obtain a ruling which would delay approval of generic competition at least thirty months (3). Sanofi also paid an undisclosed sum, perhaps billions, to Eli Lilly. In return, Lilly promised not to release competing generic Insulin Glargine to the market until December, 2016. The American patient silently paid soaring prices for Insulin Glargine for almost two years beyond the end of patent protection.

The third strategy of Sanofi was Tuojeo. Their marketing department created a name and branding strategy complete with logo and distinctive colors. The product – Insulin Glargine! Tuojeo is concentrated Insulin Glargine with a decade of brand protection. Sanofi hoped that ignorant physicians would continue to prescribe the more expensive branded Glargine product, even after cheap, generic Glargine became available. 

The examples above are only the tip of the iceberg.

The mission statement for Gilead is: “Advancing Therapeutics, Improving Lives”. There is an emptiness to that statement. It stands in stark contrast to borderline criminal pricing which dramatically limits the number of lives which can be improved by their advanced therapeutics.

The book of Judges ends with a major downer. The story of the Levite, his concubine and what followed, is not for the faint of heart! “In those days there was no king in Israel. Everyone did what was right in his own eyes.” (Judges 21:25, ESV)  The stories of the Judges describe the nation of Israel repeatedly falling away from God, falling apart, then being saved by a divinely empowered hero. The grand finale of this little book is violence, abuse of women and almost the collapse of society.

We are made in the image of God. Every one of us, as image bearers, has potential for good. We are depraved from birth. Every one of us has a bent toward sin. We make the wrong choices. Consistently. We act in our own self-interest. We repeat the mistakes of our parents.

Imagine there's no heaven
It's easy if you try
No hell below us
Above us only sky
Imagine all the people living for today

(John Lennon, 1971)

Lennon wrote of utopia, a world at peace. He felt that removing the moral underpinnings would free all of us to just get along. Poverty would end, wars would cease and the rising of the oceans would stop. I think we are drifting toward a world in which all the people only “live for today”. The thought somewhat horrifies me.

Drug companies charge outrageous prices BECAUSE THEY CAN. Their goal is to make money. What’s wrong with that? How can we say it’s wrong for Gilead to charge 1,000$ per pill if there is no such thing as right and wrong?

You and I are sinners, desperately in need of repentance and forgiveness – freely offered in the person of Jesus. When we deny that truth, we pay the price. The powerful abuse the weak. Moral relativism eliminates our ability to understand and fix these abuses. The more completely we follow Christ, the better everything works: our families, workplaces, communities, even our healthcare system.   

1.     http://www.investors.com/news/technology/can-gilead-withstand-hep-c-boom-and-bust-or-will-merck-abbvie-win/  Accessed 3/10/17

2.     http://time.com/money/4475741/insulin-price-increase/   Accessed 3/10/17

3.     http://www.fiercepharma.com/legal/sanofi-patent-deal-lets-lilly-roll-out-a-lantus-biosim-u-s-next-december  Accesses 3/11/17