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Rapidly falling costs for new hepatitis C direct-acting antivirals: potential for universal access Dzintars Gotham1, Melissa Barber2, Joseph Fortunak3, Anton Pozniak4, Andrew Hill4 1 Faculty of Medicine, Imperial College London, London, United Kingdom. 2 Centre of Development Studies, Cambridge University, Cambridge, United Kingdom. 3 Chemistry and Pharmaceutical Sciences, Howard University, Washington, DC, USA. 4 St Stephens AIDS Trust, Chelsea and Westminster Hospital, London, UK. Correspondence to: Dr Andrew Hill [email protected] Abstract THPDE0206 Cost/kg of sofosbuvir API exports Jan to Jun 2016, weighted by size of shipment Gotham D, Barber M, Fortunak J, Pozniak A, Hill A. Rapidly falling costs for new hepatitis C direct-acting antivirals (DAAs): potential for universal access. Abstract number A-792-0516-01639, presented at AIDS2016, Durban. Cost-based generic price of sofosbuvir (12 weeks) Cost of API = $1,094/kg API needed per person = 34g (400mg x 84 days) API per 12 weeks = $37 Formulation + excipients = $0.04 per pill Formulated drug = $40 Packaging = $0.35/month Packaged drug = $41 Profit margin = 50% Final generic price = $62 Gotham D, Barber M, Fortunak J, Pozniak A, Hill A. Rapidly falling costs for new hepatitis C direct-acting antivirals (DAAs): potential for universal access. Abstract number A-792-0516-01639, presented at AIDS2016, Durban. Costs of API, calculated target prices, and current prices Drug API cost/kg Target price for finished product per treatment Sofosbuvir (SOF) $1,094 $62 Daclatasvir $998 $14 Ledipasvir (LDV) $2,441 $34 SOF+LDV N/A $96 Velpatasvir (VEL) $8,900-11,700 $119-154 SOF+VEL N/A $181-216 Gotham D, Barber M, Fortunak J, Pozniak A, Hill A. Rapidly falling costs for new hepatitis C direct-acting antivirals (DAAs): potential for universal access. Abstract number A-792-0516-01639, presented at AIDS2016, Durban. Gotham D, Barber M, Fortunak J, Pozniak A, Hill A. Rapidly falling costs for new hepatitis C direct-acting antivirals (DAAs): potential for universal access. Abstract number A-792-0516-01639, presented at AIDS2016, Durban. Target $ 62 India $ 324 $ 6,875 Brazil $ 44,689 Canada $ 27,634 $ 45,323 Germany Portugal $ 45,323 France $ 27,634 $ 50,300 UK Spain $ 49,860 US (Vet. Affairs) $ 84,000 $ 90,000 $ 75,000 $ 60,000 $ 45,000 $ 30,000 $ 15,000 $0 US (list price) price for 12-week treatment course Lowest prices of sofosbuvir in selected countries $ 35,174 Spain $ 2,552 $15,000 Brazil US (Veterans Affairs) $0 Gotham D, Barber M, Fortunak J, Pozniak A, Hill A. Rapidly falling costs for new hepatitis C direct-acting antivirals (DAAs): potential for universal access. Abstract number A-792-0516-01639, presented at AIDS2016, Durban. Target $ 14 $ 37,152 UK $30,000 India $ 153 $ 39,387 $45,000 France $60,000 $ 50,653 $ 63,000 $75,000 US (list price) price for 12-week treatment course Lowest prices of daclatasvir in selected countries Estimated generic price, including a 50% profit margin, for 12 weeks of treatment: SOF: $62 SOF+DCV: $76 SOF+LDV: $96 SOF+VEL: $181-$216