An upfront cost of $84,000 for Sovaldi may look large to the average layperson, but I would caution that a professional institution has both a moral and professional obligation to present this cost in its proper context. Comparative analysis quite handily justifies the cost of the drug.
According to Transplant Living, a single liver transplant costs an average of $577,000, including for pre- and post-op expenses. The $577,000 covers the cost of 6.87 Sovaldi treatments, which incidentally enjoy a higher success rate than a liver transplant. Further, Sovaldi has significantly higher availability than donated livers, and far fewer side effects compared to transplants.
Of course, not every hep C patient receives a liver transplant. Many wait on a list for years while receiving management therapy, which has its own costs. Ongoing maintenance-type treatments end up costing more and more the longer the patient survives, in an essentially uncured state.
Digressing from traditional treatment strategies, consider that according to one study, the expense of telaprevir-based triple therapy for hepatitis C—including adverse event management—is $189,000 per sustained viral response, or 2.25 times the price of Sovaldi.
There are definite upsides to Sovaldi's quick treatment. I'll discuss a few. HCV is contagious. The sooner it is cured, the lower the risk of contagion. Chronic HCV can cause liver cancer. Having watched my father die from cancer that metastasized to his liver, I can identify with the financial and quality-of-life costs associated with this disease. A quick cure such as what Sovaldi offers will likely prevent the liver degradation, which then becomes a painful and costly cancer scenario. Finally, and this is more a tertiary cost, when a scarce commodity such as donated livers are not needed for HCV treatment, they can go to other patients.
Lastly, there is a moral obligation to consider the patient's quality of life. In 12 weeks, one can be cured of hepatitis C forever, and resume enjoying life.
Biotech companies such as Gilead spend years researching drugs, most of which never make it to market. When one drug does come to fruition, it has to carry the burden of all of the failures. I appreciate that this article does not make direct or implied slanders against Gilead. I would equally respect an initiative taken to explain to readers the drug cost in its true context, allowing an educated reader to make his own conclusions.