The first year was successful: A total of 125,000 patients have been treated with sofosbuvir. The Egyptian government’s ambitious goals are to treat 300,000 hepatitis patients a year starting in 2016 and to drive the national infection rate below 2 percent by 2025. “If you can solve the hepatitis problem in Egypt, you are a hero,” he added. “They are to prevent the black market from moving it to other countries.” Gamal Esmat, a liver specialist at Cairo University Medical School and a co-author of the national hepatitis plan. “We don’t have a problem with the rules,” said Dr. Jennifer Cohn, medical director of the drug access campaign at Doctors Without Borders, described the requirements as “a third party introduced into the doctor-patient relationship.” Giving a drug company control over who receives its products sets “an incredibly dangerous precedent,” she said.īut so far, no outrage is visible on the streets.Įgypt’s health officials also say that the deal is fair. Heba Wanis, a pharmacist who until recently worked at the Egyptian Initiative on Personal Rights, said she found the requirement to take a dose in front of the pharmacist “humiliating” and felt it “raised a lot of ethical issues.”ĭr. Those restrictions infuriated international activists pushing for greater access to medicines, who saw them as violations of patients’ rights. Those receiving new bottles must immediately unscrew the cap, break the seal and take the first pill in front of the pharmacist - making it nearly impossible to resell the bottle. In return for selling sofosbuvir cheaply, Gilead asked that Egypt impose strict restrictions on every bottle to prevent the drug from being sold on the black market and undermining its business elsewhere.Īll pills must be dispensed by government pharmacies, for example, and all patients must turn in an old bottle to get a fresh one. Wahid Doss, the chairman of the National Committee for Control of Viral Hepatitis. Egypt’s patent office rejected the company’s application, making it inevitable that generic versions would eventually be sold there, said Dr. Gilead was under some pressure to make the drug more widely available.
Gilead also allows 11 Indian and two Egyptian companies to make sofosbuvir under license and to sell it at any price they like, in return for a 7 percent royalty.
The government distributes it to pharmacies across the country, where it is dispensed free to patients. Sofosbuvir is an enormous blockbuster in its first year on the market, the drug earned Gilead more than $10 billion.īut for the past year, Gilead has sold the drug to the Egyptian government for about $10 a pill. A course of the drug, taken with ribavirin and often interferon, usually cures hepatitis C infection in 12 weeks. The company makes sofosbuvir, which since 2013 has been sold in the United States as Sovaldi for about $1,000 per one-a-day pill. Last year, Gilead Sciences, based in California, offered an alternative. The drugs are loaded with side effects and difficult to tolerate. About a quarter of his customers prefer to bring their own clippers and scissors.
“They have to see me open it with their naked eyes,” said Mr. Sherif Mechawy, a barber in an upper-class neighborhood of Cairo, pumps sanitizer on his hands and holds up a clear plastic package containing a comb and a disposable razor for each client. Egypt’s National Liver Institute runs 50 treatment centers and consumes a third of the national health budget. Manal Hamdy El-Sayed, who directs the national hepatitis-awareness campaign. There are an estimated 150,000 new infections each year, caused by reuse of disposable syringes, accidental needle sticks, tainted medical equipment, and even the sharing of nail clippers and toothbrushes among family members.Įach infected Egyptian passes the virus to three others on average, said Dr. Nowhere is the virus more entrenched than in Egypt. Some patients clear the infection on their own, but in most, it becomes chronic, slowly damaging the liver over time. Usually transmitted by contact with blood, hepatitis C may not cause symptoms for years.