Very low price means 2k/person for Egypt. It is immensely expensive for this country and not sustainable for the egyptian healthcare system.
But it's the same for developped countries. There is an inherent conflict of interest in producing a cure that heals a chronic disease. You only get the money once. So you'd better get as much as you can.
Solvadi could be paid for with monthly payments, say, 90% of the average price of conventional Hepatitis C treatment. Once the total payments add up to the price of Solvadi, they stop.
The patient gets cured right away. The healthcare system sees a 10% savings instead of a $90,000 bill. Gilead gets a smoothed-out income stream that helps to insulate it from the feast-or-famine cycle.
What's more, this places a built-in limit on the price of the drug. If Gilead sets the price too high, then the monthly payments never add up.
In a system where the patient could switch insurers, the monthly payments would have to be imposed on the new insurer. Otherwise, we're back to the US game-theory standoff.
People are looking at that already, believe it or not. Since it takes a number of years to see the benefit of curing HCV, it makes sense to spread the payments out.
The interesting thing is that Sovaldi is not more expensive than earlier therapies (last generation therapies were around $85K). The issue is that Sovaldi is so good that everyone wants to take it now, where before, very few patients were willing to put up with the old therapies.
