Month-by-month tracking of the prices paid in India for the chemicals used to make hepatitis C direct-acting antivirals shows that it is now possible to make and sell a combination of drugs to cure hepatitis C for less than $200, Dr Andrew Hill of Liverpool University told the Second European HIV Hepatitis Co-infection Conference in London last week.

If those drugs were bought at list price in the United States they would cost approximately $147,000 for a 12-week course of treatment – $84,000 for sofosbuvir (Sovaldi), manufactured by Gilead Sciences, and $63,000 for daclatasvir (Daklinza), manufactured by Bristol-Myers Squibb.

Tracking of shipments of active pharmaceutical ingredients (API) by, a reporting mechanism for importers and exporters, shows that the value of shipments of the APIs that are used to make sofosbuvir, the world’s most frequently-prescribed hepatitis C direct-acting antiviral, has fallen from around $8000 per kilogram in January 2015 to around $2000 per kg by September 2015.

Active pharmaceutical ingredients are manufactured in India and China and shipped to other parts of the world for final manufacture of a drug. tracks shipments in and out of India for a wide range of commodities by analysing customs data, which must declare the weight and value of items passing through customs.

By crunching these data, Andrew Hill and colleagues were able to track changes in the value of shipments of the APIs used in the manufacture of sofosbuvir and of daclatasvir. Using these prices, they went on to calculate how much it would cost to manufacture a finished product, using methods of calculation already validated for the estimation of antiretroviral costs. In the case of sofosbuvir, they found that even assuming a 50% profit margin for the manufacturer to cover capital investment and return to shareholders, it would now be possible to sell a 12-week course of the drug for $178.

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