For critics of Big Pharma, the lesson from this trend of medical tourism is clear: European governments must stop being so deferential toward the industry\u2019s sacrosanct patent protections and harness the power of generics. People should not have to travel to the North African desert to get decently priced medicine, they argue.<\/p>\n
\nThe pharmaceutical industry argues that, were it not for patents, nobody would have access to medicines because new cures would simply not be invented.<\/p>\n<\/blockquote>\n
The company seizing the initiative in Egypt is Pharco, which runs the \u201cTour n\u2019 Cure\u201d campaign<\/a>. It produces cheap copies of Gilead\u2019s Sovaldi \u2014 the initial blockbuster drug against hepatitis C \u2014 and Bristol-Myers Squibb\u2019s Daklinza.<\/p>\n
The two American drugmakers don\u2019t have patents protecting their drugs in Egypt, which means generic companies can produce them very cheaply. A full treatment course with Pharco\u2019s medicines costs about \u20ac137\u2009per person, said Mostafa El Sayed, the campaign\u2019s managing director.<\/p>\n
To win international cachet, Pharco paid Argentinian football superstar Lionel Messi to promote the Egyptian treatment vacation. A promotional video<\/a> featuring Messi complains that 100 million people worldwide have to wait more than two years to access hepatitis medicines. \u201cNo one should wait for a treatment,\u201d the striker says, before delivering the Tour n\u2019 Cure slogan, \u201cStop the wait.\u201d<\/p>\n
Some 2,000 people from all over the world have been treated in Egypt since the campaign was launched in May 2016, according to Tour n\u2019 Cure\u2019s manager, El Sayed.<\/p>\n
Road from Romania<\/h3>\n
Many are from Romania, which has one of Europe\u2019s highest hepatitis C infection rates.<\/p>\n
Maria Mihai, a 69-year-old woman from T\u0103rt\u0103\u0219e\u0219ti, a village an hour\u2019s drive from Bucharest, found out about the campaign from her doctor in 2016. She had been diagnosed with hepatitis C in 2004, but hadn\u2019t received any treatment because the standard therapy before the new hepatitis C drugs came on the market was not recommended for patients with hypertension, like her.<\/p>\n
She traveled to Egypt in December 2016. \u201cThis was the first time in my life I got on a plane and I was confident that everything will be alright,\u201d Mihai said. She was part of a group of five Romanians who received treatment in Egypt that week. One year later, the virus is no longer detectable in her blood, a sign that she\u2019s been cured. Mihai declined to say how much she paid for the treatment.<\/p>\n
Romania pays between \u20ac10,000 for AbbVie\u2019s Viekirax and Exviera drug combination and \u20ac15,700 for Gilead\u2019s Harvoni to treat a patient for four weeks, according to the national health payer, the CNAS. That is only a part of the cost, as the treatment usually lasts three months.<\/p>\n
While Mihai wasn\u2019t afraid to travel to Egypt, security fears have kept others away in the aftermath of a 2015 downing of a Russian jet and attacks on Coptic Orthodox churches, El Sayed said. With high demand from patients for treatment, Tour n\u2019 Cure is now expanding into one of Romania\u2019s neighboring countries with less perceived dangers: Moldova.<\/p>\n
\u201cWe can register our drugs there and Moldova is in between Romania, Bulgaria and Russia, which are big markets that don\u2019t have access to treatment,\u201d El Sayed said. The full treatment package in Moldova will be cheaper than in Egypt, at only \u20ac4,000 per person, he predicted.<\/p>\n
All in all, the treatment cost can go as low as \u20ac950 per patient, said Alexandru Constantin, the president of the Romanian Medical Tourism Association, who has helped send people to Egypt and now to Moldova. Constantin said the relatively low sum was a result of negotiations between his association and the Egyptian company. He forecast that big groups of Romanians will head across the border to Moldova soon.<\/p>\n
<\/p>\n
A Romanian activist protests funding cuts for drug users with HIV\/AIDS and hepatitis near the Ministry of Health headquarters in Bucharest on July 1, 2013 | Daniel Mihailescu\/AFP via Getty Images<\/p>\n
Fueling the debate<\/h3>\n
The inability of people such as Mihai to be treated in their home countries, where they have health insurance, adds fuel to the already intense debate about the connection between high drug prices and intellectual property rights in the developed world.<\/p>\n
The European Commission is now studying that connection, which is strongly denied by pharmaceutical companies. The industry argues that were it not for patents, nobody would have access to medicines because new cures would simply not be invented; they say there\u2019d be no incentive for drugmakers to invest.<\/p>\n
\n\u201cSometimes difficult decisions are made and health care [access] depends on the country\u2019s health care system\u201d \u2014 Graeme Robertson, senior director at Gilead<\/em><\/p>\n<\/blockquote>\n
Others disagree. In Western countries, \u201cthere\u2019s an over-attachment to patents and they don\u2019t want to rock the boat because there is a lot of lobby[ing] that goes into granting these patents to get the drugs developed,\u201d said Tahir Amin, the co-founder of I-MAK, a U.S.-based organization challenging pharma patents around the world.<\/p>\n
\u201cThere is more of an emphasis of promoting innovation regardless of the social impact it may have \u2014 it benefits society more if they grant these patents, [Western governments] think,\u201d he said.<\/p>\n
Romania toyed with the idea<\/a> of producing its own generic medicines for hepatitis C in 2015, but ended up striking a deal with AbbVie.<\/p>\n
The availability of cheaper drugs for those willing to travel to developing countries is largely an effect of the 2001 anti-pharma HIV outcry. That year, almost 40 drugmakers were forced to drop a lawsuit against the South African government, which sourced cheaper generic medicines from abroad to treat HIV patients because it couldn\u2019t afford the patented ones.<\/p>\n
Gilead launched a program offering access to HIV drugs to poor countries in 2003. It offered prices adapted to local economies and struck licensing deals with Indian generic manufacturers to bring cheaper drugs to 134 countries, said Graeme Robertson, Gilead\u2019s senior director of international access operations and emerging markets.<\/p>\n
<\/p>\n
Hepatitis C sufferers and supporters hold placards during a demonstration outside of a Gilead office in Madrid on February 5, 2015 | Javier Soriano\/AFP via Getty Images<\/p>\n
The United Nations set up a program<\/a> to check the quality of medicines and vouch for them, managed by the World Health Organization.<\/p>\n
Gilead later used its HIV drug access model for its hepatitis C medicines, covering 104 countries.<\/p>\n
It offered Egypt, which has the highest number of people with hepatitis C in the world, a price that was around 1 percent of the European and U.S. price: $900 for a full three-month treatment course, Robertson said.<\/p>\n
\u201cThe ministry of health treated over 180,000 patients in Egypt utilizing Gilead\u2019s Sovaldi and Harvoni\u201d between 2014 and 2016, he said.<\/p>\n
But with one patent that would have prevented generic production of Sovaldi rejected by the Egyptian patent office in 2014 and others pending, Pharco and other local companies started producing their own copies.<\/p>\n
<\/p>\n
Barcelona superstar Lionel Messi was paid to promote the Egyptian treatment vacation | Lluis Gene\/AFP via Getty Images<\/p>\n
Robertson didn\u2019t have much to say about that, noting just that Pharco \u201cis an organization that has commercial interests in this.\u201d He said that Gilead uses its patent policy responsibly and waives its patent rights to generic partners around the world.<\/p>\n
As for where this leaves patients in countries where patents are in place, Robertson said \u201cinnovation and bringing a drug to market has a certain cost.\u201d Governments decide how to use their resources when buying innovative drugs, he said.<\/p>\n
\u201cSometimes difficult decisions are made and health care [access] depends on the country\u2019s health care system,\u201d Robertson said.<\/p>\n
This article is part of a series on drug pricing, Pharma\u2019s Market<\/a>.<\/em><\/p>\n
Original Article<\/a><\/p>\n
[contf]
\n[contfnew]
\n<\/p>\n
<\/a><\/h5>\n","protected":false},"excerpt":{"rendered":"
Egypt does a roaring trade in treating foreigners for hepatitis C.<\/p>\n
It\u2019s all about the price of medi..<\/p>\n","protected":false},"author":1,"featured_media":68621,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[48],"tags":[],"class_list":["post-68618","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health"],"yoast_head":"\n
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