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Dr. Rebekah Gee Wants to Save Your Life

Louisiana’s Health Secretary is proposing a radically simple step to make hepatitis C treatment affordable in her state

A woman you’ve almost definitely never heard of is fighting harder than almost anyone else for your right to affordable medicine. She’s one of just a handful of lawmakers who are. And the kicker is that she’s doing it from Louisiana.

Dr. Rebekah Gee is Louisiana’s Department of Health Secretary, and she does not give a crap if the political establishment hates her. She cares about one thing: radically improving the health of one of the sickest, poorest state populations in the country.

Gee is proposing something no one in Baton Rouge would even think of if they wanted to keep their seat: calling on the federal government to step in and use a little-known law to bring down the price of life-saving drugs.

”In southern Louisiana, everyone’s had some touch of disaster in their life”

Gee once said that Louisiana is a state that knows what it’s like to have to rebuild after a disaster. And hepatitis C is one more disaster: the state has 35,000 people with hep C who are uninsured or on Medicaid. Last year, just 320 of them got treatment.

Because hep C is so contagious, curing one person early on could save hundreds of people from ever being infected at all. But 320 out of 35,000 is barely a dent, and Gee chalks that up to one single factor: the price of treatment.

She estimates that, at current prices, it would cost over $760 million to treat the state’s uninsured and Medicaid-covered population. And Louisiana just doesn’t have that kind of cash.

But Gilead, the makers of the drugs in question, Sovaldi and Harvoni, don’t take “doesn’t have that kind of cash” for an answer. The two drugs have a 95% success rate, but they also cost upwards of $100,000 for a 12-week course of treatment. Since Gilead brought their miraculous cure to market in 2014, hep C death tolls haven’t fallen at all — only climbed. In the years since their cure has been available, more than 1.4 million people have died of the disease in the U.S. alone.

A modest proposal

So, after soliciting advice from public health and legal experts, Gee has a suggestion: tap a 1910 patent law to force Gilead to either lower the price or get out of the way.

The law is relatively simple: it’s kind of like eminent domain, except instead of screwing a farmer out of his land to build a pipeline, it’s sidestepping a patent that’s being used to hold our health system hostage.

It’s called “government patent use,” and what it does is give the government a level of immunity to challenges from patent holders: in Gee’s case, her state could import generic versions of hep C treatment, or get other pharmaceutical companies to put in bids to manufacture the drug, competing for the lowest price, and Gilead couldn’t sue or do anything else to get in the way.

As the patent-holder, Gilead would still get paid, but it would be “reasonable royalties,” calculated by things like manufacturing cost (somewhere around $130) or re-couped R&D costs (we don’t know because Pharmasset, the company who actually invented Sovaldi, won’t tell us, but Gilead spent $11 billion buying them up; Gilead has already recouped that three times over, with nearly $36 billion in its initial three years on the market).

Gee’s suggestion is being framed as radical — and, in terms of red state politics, it is — but it didn’t used to be. In the ‘50s and ‘60s, government patent use was invoked pretty frequently to make medicines available at a lower price.

It’s also been used for things like night vision goggles or lead-free bullets: items the government deems critical for national defense, but aren’t priced affordably by the patent holder. Just the threat of government patent use in 2001 to make anti-anthrax tablets affordable was enough to get Bayer to “voluntarily” cut their price in half.

Cue the usual suspects…

In some ways, the backlash against Gee has been swift and predictable. Gilead issued the standard threat about taking their ball and going home. Louisiana’s Senator Cassidy (yep, that Senator Cassidy) made a Very Serious face and delivered some industry lies about “innovation.”

And online outlets have joined in. “Rebekah Gee Is Now Publicly Talking About Stealing Drugs to Treat Hep-C in Louisiana,” one local news site screamed. Never mind the fact that if Gee is proposing “stealing” from anyone, it’s from Big Pharma — in order to give to the very jerk who wrote that headline.

But in other ways it’s been surprisingly quiet. I think that’s largely about how well-timed this is: Gee is in a state that simply cannot pay for these meds, no matter how many tax breaks they give out. We’re all pretty fed up with being price-gouged to death, literally. And pharma’s back is to the wall here; it’s not a coincidence that the industry lobbying group, PhRMA launched a huge PR campaign this year to repair their tattered reputation.

Reminder: Big Pharma does not care about you

One more time for the inevitable clowns in the comments: Gilead did not spend billions of dollars to invent these drugs. They did not invent them at all. They bought them. They do not need your help to recoup their R&D costs. When Gilead bought up the drug, they made their money back in a single year. And Gilead’s CEO made at least $28 million in 2016.

Why anyone spends any energy defending them, especially if they’re not getting paid, is literally incomprehensible to me. I do not understand it.

Dr. Rebekah Gee is one of the only people putting forth a real solution to this crisis. She’s doing it in a state where the governor will likely want to stop her. And if PhRMA is mad, you know someone’s onto something.

Look: if there’s a fight brewing, and on one side is a mind-bogglingly profitable mega-corporation, and on the other is an OB-GYN who brought Louisiana’s infant mortality rates down by 25% and is brave enough to stick her neck out like this, I know which side I’m getting on.

Written by Caitlyn McClure

Caitlyn is the Director of Development at Other98.

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