The same hepatitis C drug that costs $US1000 in the US costs just $US4 in India.

Outsiders don’t want their daughters to marry any local boys, according to the village elders swapping stories in a tailor’s shop behind the Sikh temple, because most residents are infected with “black jaundice”.

That’s what they call hepatitis C, which is so common in parts of India’s Punjab state that the tailor-shop gossips might not be off base in their estimate. But prevalence could be something of an advantage these days.

Drugmakers have made the village of Lande Rode one of the theatres in a battle to grab market share for sofosbuvir, a miracle cure that Gilead Sciences sells in the US as Sovaldi at a retail price of $US1000 ($1200) a pill. Gilead licensed 11 Indian companies to make generic versions, and they sealed marketing deals with others. Competition has been so fierce it’s driven down the cost and spurred thousands to be tested.

Manufacturers “want more and more patients” and are willing to wheel and deal on price, said Nirmaljeet Malhi, a gastroenterologist at Apollo Hospitals in Ludhiana, about 200km from Lande Rode. “If one agrees to it, the others will also have to. It’s a race where one cannot say no – because then they’re going to lose the business.”

The companies sponsor screening drives, hand out free test kits to hospitals and offer bulk discounts to entire villages. Sofosbuvir was cheap by almost any standard when it hit the market in Punjab at $US10 ($12) in March. Then the cost kept dropping, to as low as $US4.29, and doctors predict it will continue to fall.

That’s in contrast to the situation in the US, where Gilead set off a firestorm in December 2013 by listing Sovaldi at $US84,000 ($116,200) for a 12-week course regimen.