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lower their prices. consumers hope that is sooner rather than later do checkout the website. it's always there for you. lots of news 24/7. that's aljazeera.com here's the problem, some patients can't get it fast enough to save their lives. much of the recent outrage orover rising rice rising pricer prescription drugs is martin screlling. he decided it would be okay to
500%. his business plans involve buying old prescription drugs and jacking up their prices. the the plan is that undermining the strategy by speeding up the approval process by competitors to older drugs which are made by just one company. but older drugs are not the only problem. in 2014, overall spending on prescription drugs in america billion. this is five times the increase from the year before. one big reason for that spike: expensive new drugs that can cure hepatitis c. an estimated 3.5 million americans are infected by hepatitis c. it's a potential fatal virus
that can kim. often in effect drunk users that share dirt 80ed in les. cure rate for helpc called harvoni, made by a company called gilliad scientists. one time cost of harvoni appeals in comparison to the lifetime cost of treating the disease but the huge price tag seems to be key reason many patients who are prescribed harvoni are denied approval of the drug. a man name id gene calvo, whose stepson works on this show as a video editor.
gene's best hope was out of reach. gene had medical insurance, but while his body battled a life threatening disease, the company seemed to be .more interested in profits than people. mary snow has the story. >> he had that gruff exterior but he was like a teddy bear inside. he was very living. >> both were nearing 50, they wednesday in 2003. >> this was the one i was meant to be with, my best friend. >> but soon after a call came that would change everything. gene's long time friend michael revealed he had been diagnosed
with hepatitis c, the cause ever liver cancer. >> we had done a lot of similar things, to our youth, we did experiment with a lot of different drugs and things like that. >> reporter: the two men had shared needles, one of the leading way the infection was spread. he said their experimental drug phase ended in the 1970s when he enlisted in the army and was sent to germany. >> they were young, did drugs, but it wasn't something that they did for 35 years but one of the things that catches up to you. >> it caught up to gene. he tested positive for hepatitis c in 2003. doctors treated gene with interfer
interfere on, but it didn't work. $94,500 three month course of treatment for harvoni. >> this was going to be cure-all, according to everything we read, 94% of the people are cured. so he felt good about it. >> but gene and karen quickly learned getting approved for harvoni would be a struggle. his be insurance was through aetna. through two different doctors, gene was denied twice. the second denial said karen stated that gene wouldn't take illegal drugs or alcohol but karen says they did send that letter. >> i couldn't believe it. we actually called them, i never forget, my husband got on the
phone and said to the representative who picked up he said you know you just put a nail in my coffin. >> the couple began a serious effort to unravel the situation and get approval for harvoni. gene's doctor who declined to speak to us, wrote a letter on september 2nd. said, the patient is cerotic, the patient must be started on this immediately. it would be malpractice to not approve of this treatment. on october 28th, an alternate review board upheld the -- an external review board upheld the denial. >> it's not something you can just fork over. >> i wish i could have. but i don't have that kind of money. because if i did, it was -- if my house was worth that much i would have done anything.
this was my best friend, this is my husband. >> reporter: as gene got sicker karen reached out to a health advocate and her congressman. her son, a film editor on al jazeera america, brought attention to his stepfather's case on social media. >> 5:30 that afternoon i gt a phone call that he was approved. >> how did that strike you? >> little strange, little coincidental, on social media and ho now you are approving me. >> in one day? >> in one day. >> a bottle arrived on november 30th, five months after the doctor prescribed it. >> what happens with harvoni you can't stop, you can't skip a day. because he was so sick he didn't want him to start it until he knew he could take it straight through.
>> karen says gene was supposed to be taking the medication within days but plans changed when he was rushed back to this hospital. what remains unclear is why gene was denied coverage for months and then suddenly approved. we reached out to envision pharmaceutical services, that's the company responsible for approving gene's medication, envision claims it couldn't comment on gene's case because of medical privacy laws. he had been approved for harvoni and well into his treatment when he visited gene in the hospital. >> it's like polar opposites, him and i where he's deteriorating and i'm fine. >> what does he tell you? >> that he was afraid of dying. >> did he talk a lot about the drug? >> yes. it was is a hope. >> how angry was he that he didn't get it?
>> very. very angry. >> how likely you succeed really depends on how hard you try. many patients be and physicians after that first turn-down will give up. >> reporter: liver specialist robert brown did not treat gene calvo. but it's not unusual he says for patients to try numerous times to get approval for hepatitis c drugs. >> it could take two or three times, i personally be advise my patients to make personal peams. >> he's seen hundreds of patients cured of hepatitis c but also seeing insurers taking on a larger role. >> any time it takes six to eight weeks for me to get approval for an fda approved medication being used according
to its fda approved indication, in a patient that i need treatment, the insurer is overstepping its role of provider ever insurance benefits. >> as karen calvo found out weeks made all the difference. gene spiraled into stage 4 liver failure. the bottle of harvoni at a was frooived was ni that wasapproved was in sight but not usable. >> probably, within 40, 45 minutes, i never let go of his hand and i know his best friend was holding his other hand. >> i knew it was the end.
the i'm glad i was there for him. >> as he mourns his friend michael has since learned that his body is now free of the hepatitis c virus. both he and gene's widow are plagued with the question of what if? >> in my heart of hearts, if he got it in the end of august, beginning of september he would have been on it for like three months. he would still be here, maybe he wouldn't be 100% but he would still be here. >> mary snow joins me now. it strikes me this was about money. if they had had the money and able to pay for the drug gene would have been alive. >> karen feels it's about the money. gene was prescribed two courses of treatment. $190,000, money she doesn't have and wasn't able to
borrow. harvoni treats the virus, not the complications that come from the disease. if he had been on the anti-viral he would have been better prepared to fight the disease. >> when the doctor says he needs the medication, when the company takes six weeks to approve it they are overstepping the bounds. are the insurance companies getting any heat for this? >> we are seeing a bit of a focus on this situation, here in new york state, the attorney general's office has opened an investigation over these hepatitis c drugs against the insurance companies. we have a source that tells us the attorney general's office is seeking documents from 16 insurers that operate here in new york state, obviously the big question is how is this
coverage denied, how is it approved. this case happened in new jersey, not affected in this investigation, but we see some of the focus shifting to insurance companies. >> mary thank you very much. modern medicine has found a way to cure one incurable disease, but getting the medication to the patients, quickly enough to be effective, that's unacceptable, this is
>> you just heard this heartbreaking story of a man infected with hepatitis c who died months after his doctors prescribed harvoni. the drug might have saved his life but approval came too late. now gene calvo had private insurance and research suggests low income patients without private insurance face even
worse odds in getting approval for hep hep c drugs like harvoni. our next guest says states simply don't have the budget to make the meds available to everyone who needs them. matt sale, joins us from washington. matt thanks very much for being with us, you heard that story of gene and part of the nuj numbering part of the story, gene had insurance which was bungled in the system. medicaid insure the poor across the country. but when it comes to drugs like harvoni, most states don't provide the care until the.disease
has advanced. how is that the case? >> this drug is being priced out of reach by the manufacturers. it is not insignificant othink of a price tag that is $94,000 or $200,000. now, i want to be very clear that medicaid is the nation's hearlnation'shealth care safety. we provide care for oldest sickest most medically complicated patients in the country. are this is not unusual but what's different here is we've had kind of a social contract in the pharmaceutical world for many, many years where you ask charge orphan drug prices, for orphan drugs. so medicaid doesn't bat an eye when we're paying $400,000 a year for treatment of kids with cystic fibrosis because it is a relatively small number of people.
but when we look at hepatitis c, three and a half million americans, more than a million of those are on medicaid. >> right. >> and when you do the math of more than a million people on medicaid who need a 94 or $194,000 treatment, all in one year, that just sends the budget into cardiac arrest. it can't be done. >> so harvoni is 93, 94, $95,000 for one course. our patient who we profiled gene needed 2. let's cawg it $95,000. medicaid receives a discount which can be half of that but even then, you say it can be too competitive for every patient who needs it. in what point in mary snow's story, if it's not medicaid or
the insurers's role in the middle that they don't? >> medicaid a payor and a tax funded institution has got to be a responsible steward of the taxpayer dollar. and we need and we want both the patient and the physician to be strong advocates for what they want and what they need. but the state does have a legitimate role to say okay, well if we did this on a broad policy for everyone, then the costs, we run the numbers. if we were to make this available to everyone, we would literally be spending as much on this one drug or this class of drugs as we would on literally every single other drug in the entire system combined. so you're talk tens and tens of billions of dollars in a year. and if that happens, then states are going to be forced to make very, very serious tradeoffs which could jeopardize patient safety or patient access in a
whole lot of other areas. so, you know, these are kinds kind of decisions that medicaid has to make all the time. >> i'm from canada and medicaid is as close as you come as a buyer. doesn't medicaid have the ability to go to these insurance companies and say we got so work out a better deal than this. this is not feasible and if we are such a big buyer of your drugs don't you have the ability to force those prices down? >> we have limited ability. and trust me, we have used every tool at our disposal to try to bring the price down as much as possible. like you said we have been able to bring the pricing down 50, 60% or so at most. but with this magnitude of patients? this starting cost that's still not enough. and the challenge is when you
talk about leverage, the key to leverage is having the ability -- >> to walk away. >> yeah. >> if you are going to go buy a car and your leverage, if the car dealer knows at the end of the day, you have to walk out of that dealership with a car, you don't have any leverage no matter how many cars you're buying. >> matt salo is the national director of medicaid directors. iraq and syria coming up next we go to the front lines in a new fight against i.s.i.l. >> people loved him. teachers loved him. >> we were walking the river looking for him. i knew something was really really wrong. >> all hell broke lose. >> people were saying that
and antiquities experts are the people among the most interested to examine the damage. and they're shocked to be sure. some of the sites were six, seven, even 8,000 years old. the head of the united nations cultural arm declares the destruction a war crime. now, the advent of laser scanning and 3d software, is allowing archaeologists to quickly document at risk sites and prepare for the absolute worst case scenario. here's mary snow. >> reporter: this fortress is one of the oldest and largest in the world. until war eresulted, the citadel in aleppo, got started in 25 bc as a shrine to the storm god hada. but it's caught in the cross
fire of war. >> people essentially lived continuously for five or 6,000 years on that site and it was still used as a citadel through ottoman era. >> this is how it's used now. its dungeons and arsenals are part of the war between the syrian government and i.s.i.l. fighters shoot from slits in walls. the extent of damage to this ancient site is not known, the worst is expected for the shrine within it. >> two years ago, absolutely horrible photographs arrived in my inbox, showing that the inside was dismantled. in these photographs we could make up one or two of the sculpture on the ground.
>> lisa ackerman is executive director of the world fund. two years ago, her organization took lays are sculptures which were made into this 3d animation. ackerman fears it may be the only documentation of the site. >> when you see news views of this site, for you it's very personal isn't it? >> it is very personal but now, if it's really true that this area has been badly damaged because of the war at least the knowledge of those 23 basalt releafs exist. there will be a record of them. not as great as having them. >> reporter: ancient sites in the middle east are not just getting stuck in the cross hairs of war they are being purposely destroyed. in the last two years i.s.i.l. has destroyed dozens of templ temples, mosques and countless artifacts.
in february 2013, i.s.i.l. smashed many club sculptures and an ancient city in iraq, founded in the third or second century bc. that same month, i.s.i.l..destroyed num nimrud. are palmyra, an ain ancient city that had been incredibly well preserved by the sands of the desert. there doesn't seem to be a way to stop the destruction. >> it's too dangerous basically to go in and preserve things in the middle of this conflict. >> reporter: something else that will play a major role in reconstruction: technology.
specifically, laser scanning. let's say there's a lays are scanning of the empire state building. that scanning would be able to take dimension of every nook and imaging. it is a useful tool for archaeologists and historians. that technology has also taken on a more urgent purpose. >> it was really shortly after the destruction at the mosul museum and added sites at northern iraq like hatra that we said we have to do something. >> reporter: nonprofit organization sciarc is working to lays ir-scan sites that are most at risk of being destroyed. that data can be turned into a blueprint or virtual model. in cases of sites already destroyed there are several groups like the mosul project
that are crowd sourcing identification of the projects for future reconstruction. >> this can give us some idea of the things that have been lost. >> other organizations like the american school of oriental research are monitoring by satellite image and sources on the ground and providing weekly upstairs of the destruction. >> it's all about documentation. right now. without documentation we won't know what we are missing. so it will be much harder later to restore anything. >> mary snowy al jazeera. >> that's our show for today, i'm ali velshi, thank you for joining us. >> al jazeera america - proud to tell important stories of native lives. >> oak flat to the apaches is an ancestral place. what'll happen to this after the mine...this will sink away and be destroyed. >> were the apache consulted on
this before it was put into the defense bill? >> no we were not consulted at all. >> it takes a military bill to again attack the apache. >> the mining operation will generate $61 billion of economic benefit >> look at all the things they took from us. seventy percent unemployment. that already tells you where its going. it's not going to benefit anybody here. >> we are being left behind. >> we don't have economic development that we should have here. >> we need to be out there telling them what we need and what's required to take care of our people. >> any time they see a social worker it's like seeing a police officer. the immediate response is they are here to take my kids. >> the continuing legacy of anti-indian sentiment, while it may not be as vicious and overt as it once was, the fact is american indians remain at the bottom of every socio-economic indicator. >> louie is an example of what makes this 95 percent native american school work. a former student who cared enough to come back home and help. >> they're really pushing for education, really pushing for people to go off and go to
college, but then to come back and apply it here where it counts. >> we said why not video games. >> that's really cool. it's an evil spirit. >> we're a living culture. we're a strong culture. >> this game is to celebrate. >> al jazeera america - proud to tell your stories. >> america takes bravery to heart... >> that's a code that we live by... you leave no brother behind. >> ...and honors it's heroes with medals. >> ...bullets were hittin' everywhere.