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Sovaldi, a daily oral treatment for hepatitis C, costs $1,000 a pill. (Courtesy of Gilead Sciences)

Costly Hepatitis C Pill Shreds Drug Industry Sales Record

by Scott Hensley
Apr 23, 2014

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The launch of Sovaldi, the $1,000-a-day pill for hepatitis C, is shaping up as the most successful ever.

The Food and Drug Administration approved the pill in December. And then Gilead Sciences was off to the races. The company said it sold $2.27 billion worth of Sovaldi in the quarter that ended March 31. $2.27 billion!

The boffo number beat Wall Street's estimate for the quarter by more than $1 billion.

Sovaldi is the first hepatitis C pill that doesn't have to be accompanied by interferon for some types of hepatitis. Sovaldi has been found to be remarkably effective, essentially curing 90 percent or more patients with a common form of hepatitis C in 12 weeks.

"Sovaldi's profile has the potential to transform the treatment of hepatitis C, and the rapid uptake speaks to a significant unmet medical need," Gilead CEO John Martin told analysts and investors during a Tuesday conference call.

But the price of the drug has drawn fire. "The predicted costs of the new oral antiviral agents are as breathtaking as their effectiveness," said an editorial in a recent issue of the New England Journal of Medicine. "Costs alone cast a pall over the stunning success in achieving the long-hoped-for goal of a safe and effective therapy for hepatitis C."

In December, Gregg Alton, a vice president at Gilead, said the high price is fully justified. "We didn't really say, 'We want to charge $1,000 a pill,' " Alton said. "We're just looking at what we think was a fair price for the value that we're bringing into the health care system and to the patients."

In Tuesday's conference call, analysts peppered Gilead management with questions about the company's talks with insurers about covering the treatment. One approach to contain costs would limit the use of Sovaldi to patients with more advanced hepatitis C, marked by significant scarring of the liver.

"I do not believe it's justified medically to prioritize and restrict the cure of hepatitis C. It may be necessary economically," said Norbert W. Bischofberger, Gilead's head of research, during the call.

The Centers for Disease Control and Prevention estimates that 3.2 million people in the U.S. have chronic hepatitis C infections. Most of them haven't been diagnosed.

To make the case for Sovaldi's price, Gilead put together a chart of hepatitis C treatment costs for a variety of medicines. A combination of Sovaldi, a common form of interferon and the antiviral ribavirin, would cost $94,078 for treatment that would last 12 weeks. Other drug combinations that would take longer for treatment ranged from $64,825 to $106,673.

One of the alternatives to Sovaldi is Incivek, made by Vertex Pharmaceuticals. And it was Incivek, approved by the FDA in 2011, that held the record for the fastest launch — $1.56 billion in the first year — until Sovaldi smashed it last month, according to figures from the industry watchers at EP Vantage.

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A sign outside Lou Caracciolo's winery, Amalthea Cella (via Facebook)

Episode 444: New Jersey Wine

Apr 23, 2014

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Note: Today's show is a re-run. It originally ran in March, 2013.

Sometimes your success depends on how your competitors behave. People judge you not just by your product, but by the product that your rival down the street makes.

This is a problem for Lou Caracciolo. He's trying to make high-quality wine, from grapes he grows in New Jersey. But Jersey wine already has a reputation — and fancy isn't it. On today's show: Can New Jersey become the next Napa?

For more, see Adam Davidson's latest NYT Magazine column, Bottle Bing.

Music: Bon Jovi's "Livin' On A Prayer" Find us: Twitter/ Facebook/ Spotify. Download the Planet Money iPhone App.

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Free software is fun! (Flickr)

In Age Of Custom-Tailored Ed Tech, Teachers Shop Off The Rack

Apr 23, 2014

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The big names in the growing education-technology industry gathered in Arizona this week.

The "Education Innovation Summit" styles itself the "Davos of ed-tech." Educators, philanthropists and political leaders like Jeb Bush rubbed elbows with the investors, venture capitalists, big companies like Microsoft and small companies hoping to get big. It's hosted by Arizona State University and GSV, a private equity firm.

The event builds on the hype that there's a vast field of education spending out there waiting to be exploited, like an oil field ripe for drilling. And concurrently, that technology offers the clear path forward to reshaping education. GSV has a white paper on its website titled, "American Revolution 2.0 — How Education Innovation is Going to Revitalize America and Transform the U.S. Economy."

But amid the news to come out of the conference was a report by the Bill & Melinda Gates Foundation that detracts somewhat from the boosterism. The foundation surveyed more than over 3,000 teachers about almost a thousand digital classroom products — from hardware such as interactive whiteboards to free websites like Wikipedia.

The findings portray an industry that still struggles to deliver tools that actually help teachers and students do their jobs.

The fine print:

— On the supply side, in 2013, investors funded a total of 115 new products aimed at K-12 students, to the tune of $262.1 million. That was more products, but less cash, than the year before. The authors predict a growth in the market over the next few years, as schools buy up Common Core-aligned digital materials and equipment to administer computer-based tests.

— On the demand side, teachers surveyed recognize the value of tech tools for delivering instruction in new and varied ways; diagnosing learning needs; meeting each student's individual needs; supporting student collaboration and interactive experiences; and giving students opportunities to practice skills independently.

— Yet, just a bare majority of teachers - 54 percent — perceive the digital products that their students actually use frequently to be "effective."

— And teachers are just as likely to find free products — whether open-licensed or ad-driven — useful as those their school district had to pay for.

And there was even more sobering news for many of the companies at this summit who are pouring millions into education-specific products: The survey found teachers just as likely to rate as "effective" general purpose tools like Google, Wikipedia, and Prezi, as they are products built specifically for the education market.

A key factor in that effectiveness rating was not the brand or the product, but whether the teacher had a say in choosing it. If so, that teacher was 30 percent more likely to call it effective.

So, at a time when school districts are signing multimillion dollar, multiyear deals with hardware companies like Apple and software providers like Pearson, the Gates Foundation survey finds teachers are just as happy — in fact, even happier — going on Google or Pinterest to find free resources of their own. Is there something wrong with this picture?

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Angelina Jolie plays the spiteful protagonist in an upcoming movie called "Maleficent," based on "Sleeping Beauty." (Walt Disney Studios Motion Pictures USA)

Why Are We Spiteful, Even Though It Bites Us Back?

by Maanvi Singh
Apr 23, 2014

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Maybe you turn up your music when your neighbor complains about the noise.

Or maybe you curse a baby princess because you didn't get invited to her christening, as in "Sleeping Beauty" and its latest incarnation, the upcoming movie "Maleficent."

To see spite in its purest form, try brunch in New York. At the hippest restaurants, patrons will linger at their tables long after they've paid the bill, just to show those losers on the wait list who's boss - even though they're wasting their own time in the process.

Why do people willingly inconvenience or even harm themselves in order harm others? And why are some of us more spiteful than others? Being aggressive and lacking empathy might have a lot to do with it, researchers say.

"Spite can become very destructive," says David Marcus, a psychologist at Washington State University and the lead author of a study published in the journal Psychological Assessment.

Someone in the midst of a divorce may hurt themselves financially or even risk alienating their kids just to get back at their ex. Suicide bombers give up their own lives in the process of trying to hurt others.

And even though spiteful feelings are universal, the emotion has been little studied.

Marcus and his colleagues asked 1,200 people to rank how firmly they agreed with statements like "I would be willing to take a punch if it meant someone I did not like would receive two punches."

The researchers also had the participants complete a bunch of personality tests to gauge how aggressive or agreeable they were.

The results show that some people's personalities do make them more prone to spiteful behavior. Traits like aggressiveness and callousness closely linked to spite, while people who were more guilt-prone or conscientious were less vindictive.

And the researchers found that men tended to be more spiteful than women, and that younger adults were more vindictive than older adults.

But the researchers still aren't able to directly match up a person's personality traits with their spitefulness score. "If two people are five points apart on the aggressiveness scale, I don't really know what that means," Marcus says.

If he figures that out, Marcus says, it could help us better understand self-destructive behaviors. And it could help psychologists better diagnose personality disorders like borderline personality disorders and oppositional defiant disorders. Spitefulness is a symptom of both, Marcus says, "But as of now we don't have a good way to assess spitefulness."

More research might also reveal when spitefulness is actually productive. "Anytime people engage in a boycott, they're engaging in spiteful behavior," Marcus says. "But while some boycotts can be just petty, others some can be socially productive."

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A Minke whale photographed in Antarctica last year. The Minke, the smallest of the baleen whales, turned out to be the mysterious "bio-duck." (Barcroft Media/Landov)

Scientists Pinpoint Source Of Antarctic 'Quack'

Apr 23, 2014 (All Things Considered)

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For decades, researchers and submarine crews in icy waters off the coast of Antarctica have been picking up a mysterious quacking sound.

The "bio-duck" as its called, has been heard on-and-off since Cold War patrols picked it up on sonar during the 1960s.

"It goes 'quack, quack, quack, quack," says Denise Risch, a marine biologist with the National Oceanographic and Atmospheric Administration. "It has this almost mechanical feel to it."

Some thought it might be a secret Soviet sub. But over time they came to realize it was an animal. It got a name: the "bio-duck." Although whatever was making this sound had to be a lot bigger than a duck.

"The sound is very intense, it's very loud, so the thought was it's probably a larger animal producing the sound," she says.

As researchers gathered more data, a suspect emerged. The Antarctic minke whale. Not much is known about this particular whale. They're the smallest of the baleen whales; they're solitary; and they tend to stay very close to dense sea ice.

"That makes them quite hard to study too and that's also part of the reason why the signal has not been identified earlier," Risch says.

But last year, during the Antarctic summer, a team from Duke University was studying the behavior of these whales. They attached an instrument package to one of the whales using suction cups. On board was a microphone. Briefly, in one of the recordings, was a muffled, up-close version of the quack.

"They don't sound alike, but the pulses are exactly 3.1 seconds apart from each other," she says.

The same as the quacking.

The frequency of the noise matches too. Risch and her colleagues published their work in the journal Biology Letters.

So, mystery solved. Well, sort of.

Scientists still don't know why or even how these whales quack.

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