Hi Jason,

it's not exactly pennies we're talking about.

With 20,000 patients not having medication coverage and a list price of over $100,000 NZD it adds up to 200 billion pennies. With a penny being ~2 mm thick if we stacked them all up the stack would reach 400,000 km - literally all the way to the moon.

$2 billion is quite a chunk of change.

The real problem, and one that isn't being fixed, is the shareholder push to maximise profit.

Indeed, but it was not always so.

The chairman of the US company, Standard Oil, stated, in 1946, that the business of companies should be carried on ‘in such a way as to maintain an equitable and working balance among the claims of the various directly interested groups — stockholders, employees, customers and the public at large.’[1,2]

1. https://books.google.com.au/books?id=oS9EzyyJaagC&pg=PA59
2. http://www.austlii.edu.au/au/journals/SydLawRw/2007/23.html

Sadly, times have changed.

To add insult to injury Big Pharma, and Gilead in particular, are extraordinarily efficient in avoiding taxes [3]

3. Rubin R. Gilead avoids billions in U.S. Tax on its $1,000-a-Pill drug. Bloomberg; 2015 [updated 2015 Feb 27;]. Available at http://www.bloomberg.com/news/articles/2015-02-26/gilead-avoids-billions-in-u-s-taxes-on-its-1-000-a-pill-drug

Dr Andrew Hill from the Chelsea and Westminster hospital and I penned an article in Liver International about the Hep C drugs and their development costs.

In short Sofosbuvir was proven up for a total sunk cost of $281 million by a NASDAQ listed company called Pharmasset and we know this with real precision as this drug was Pharmasset's only product. Gilead bought Pharmasset and made $31 billion out of these drugs in the first 3 years - also a matter of public record. Since the article was published Gilead have made over another $10 billion, so the total ROI is now 160x funded by government and insurers.

http://onlinelibrary.wiley.com/doi/10.1111/liv.13157/full

For completeness Gilead purchased Pharmasset towards the end of 2011 for $11 billion (a substantial premium over it's $7 billion valuation on the NASDAQ) so have made 4x their money back in the last 5 1/2 years. They have done this despite taking NONE of the initial development risk - they just bought the patent. During that 5 1/2 years about 1 million people have been treated with Gilead medication. During the same period around 4 million people died of Hep C and the infection rate remains higher than the cure rate.

In other words a cure has been invented but we have made next to no impact on the disease.