A revolutionary new drug that treats Hepatitis C is igniting a critical debate at the heart of healthcare delivery. Sovaldi, the biotech drug, carries a price tag of nearly $100,000 for less than three months of treatment and has the industry in a panic: Patients demand it but insurers and the federal government fear they can’t afford it. Its benefits are undeniable. Its costs are unmanageable. What do we prioritize?
While Sovaldi will significantly improve the painful journeys of Hep C patients, it will likely blow a hole in our country’s balance sheet. A Kaiser executive whom I recently had the pleasure of hearing speak, Dr. Artie Southam, observed that should all of the estimated 3-6 million undiagnosed Hepatitis C cases get diagnosed and subsequently treated with Sovaldi, the costs would amount to approximately a half-trillion dollars. Yes, TRILLION. Our entire healthcare spend is $3 trillion. This one drug is anticipated to add up to 2% to medical inflation in 2014.
New drug and other healthcare advancements, which can be extremely effective but are unsustainably expensive, will soon be a part of debate. In this new world order, someone will need to weigh the benefits of quality of life improvement and delayed mortality against economic viability.
The real sin of the administration repeating the inaccurate statement “If you like your health plan you can keep it” was not so much that it was deceptive (I don’t believe it was intended to deceive) but that it created this fictitious notion that there are no tradeoffs in healthcare. Now, with economic assets limited, how we deliver and pay for care ultimately decides who lives and who dies. To address our unresolved healthcare crisis, this is the conversation politicians must have.