Scores of life-saving medicines are sold for much lower prices in India, attracting foreigners who have been denied access to, or can't afford, them at home.
Sofosbuvir, a drug for the treatment of hepatitis C, is one of the drugs people fly halfway across the world for. It costs $84,000 for a 12-week course in the U.S. but can be purchased for just $500 in the South Asian country.
Drug pricing has come under intense public scrutiny in the U.S. after Martin Shkreli, as CEO of Turing Pharmaceuticals, hiked the price of a medication used by HIV/AIDS patients from $13.50 to $750 per pill, earning him widespread condemnation.
Much of the controversy has focused on drugs that are used by relatively few people. Sofosbuvir, however, is in a different class.
An estimated 80 million people are affected by hepatitis C in the world.
According the World Health Organization, prices of hepatitis C treatments are unaffordable globally and put a major strain on national health systems. Hepatitis C can cause liver cirrhosis and cancer, and the disease could lead to 700,000 deaths per year worldwide, suggesting that governments and industry stakeholders should develop and implement fair pricing frameworks.
So how does India manage to have such cheap prices?
India does not grant patents for minor improvements to existing drugs and it is very strict in limiting what can and cannot be patented. Instead, developers must prove they have made a significant scientific advancement.
“India’s refusal to recognize patents on some of Western drug makers’ most profitable medicines has been the cause of considerable rancor between New Delhi and governments in the U.S. and Europe, who say India is failing to adhere to global intellectual-property rules,” wrote Geeta Anand in her blog in The Wall Street Journal.
“When you weigh the need to stimulate innovation by rewarding it against the imperative of making life-saving inventions accessible to people, India’s approach surely makes sense.
"New products aren’t developed in a vacuum, after all. They rely on generations of discoveries to which a whole population — indeed a whole world, is the legitimate heir,” she added.
Janice Lee is a pharmacist who worked with medical teams in Doctors Without Borders/Médecins Sans Frontières (MSF) before she started work with Access Campaign to identify potential new sources of drugs that could be of use to MSF’s work treating patients in developing countries.
“Our reliance on Indian generic drugs for treating patients with HIV/AIDS across all our programs in MSF is particularly acute — around 80 percent of the AIDS medicines we use are generic drugs made by Indian companies. But it’s not just AIDS. In other projects too, we also routinely use Indian generic drugs to treat other diseases, such as TB, malaria and a wide range of infectious diseases,” she said.
Greg Jefferys, an Australian who runs an informal India-based "buyers club," is one of the sources to supply people with such prescription drugs. He uses his knowledge and experience to look for and make the most of loopholes in international patent law and drug regulation in order to supply cheap medicine to people in need.
"There's millions of people with this disease in the world," Jefferys said. "People are dying because a really cheap drug is being marked up."
He isn’t the only option, however. There are more than a dozen websites and apps like GoodRx and WeRx out there helping U.S. consumers find the lowest prices for prescription drugs by comparing prices and searching for deals.
But the Food and Drug Administration is wary of people going for online solutions. They warn consumers about the possible dangers of buying medicines over the internet.
“Buying prescription and over-the-counter drugs on the internet from a company you don't know means you may not know exactly what you're getting,” the FDA says on its website.