When does Big Pharma profiting become profiteering? This issue was the subject last month of a Senate Finance Committee investigation of pricing practices of Gilead Sciences Inc., a leading provider of hepatitis C medications. After examining 20,000 pages of internal company documents, looking at Medicaid data and interviewing health care experts, the authors concluded that the Foster City drugmaker “pursued a calculated scheme for pricing and marketing its hepatitis C drug based on one goal: maximizing revenue regardless of the human consequences.” Community activists protested this kind of Big Pharma greed in front of the San Francisco hotel where the 34th annual J.P. Morgan Healthcare Conference opened Monday.

With the hepatitis C virus affecting about 3 million people in the United States, the impact of Gilead’s pricing strategy is real, measurable — and devastating. With a 12-week course of Gilead’s Harvoni priced at nearly $100,000, taxpayer-funded Medicare Part D spent $4.6 billion on hepatitis C alone in the first half of 2015, leaving seniors and disabled persons with the prospect of higher deductibles and maximum out-of-pocket costs. Twenty-nine states said that hepatitis C was their most or second-most-costly pharmaceutical outlay, resulting in only 2.4 percent of affected Medicaid enrollees undergoing treatment.

When insurers refuse to pay for treatment, all but the wealthy are left at risk for cirrhosis, liver cancer and death. While anticipating record profits of $30 billion in 2015, Gilead virtually eliminated its medication assistance program for all but the few Americans ineligible for coverage under the Affordable Care Act. The reason? They felt that insurers were taking advantage of their generosity.

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