Opinion | Ethics Consult: Wrong to Offer Cheap, Pirated Version of Drug?

Welcome to Ethics Consult — an opportunity to discuss, debate (respectfully), and learn together. We select an ethical dilemma from a true, but anonymized, patient care case. You vote on your decision in the case and, next week, we’ll reveal how you all made the call. Bioethicist Jacob M. Appel, MD, JD, will also weigh in with an ethical framework to help you learn and prepare.

The following case is adapted from Appel’s 2019 book, Who Says You’re Dead? Medical & Ethical Dilemmas for the Curious & Concerned.

Several new medications for hepatitis C, a disease that often leads to liver failure and cancer, are available on the market. These new medications have many fewer side effects than older, interferon-based medications, which can cause debilitating psychiatric symptoms. However, the manufacturers charge more than $50,000 for a 12-week course of treatment. ProfitMeds owns a patent on the medication and has spent nearly $100 million to develop it. CheapMeds, a company in India, has reverse engineered one of these medications and has started to market it for $1 a pill — making the entire cost of treatment available for $84.

Jacob M. Appel, MD, JD, is director of ethics education in psychiatry and a member of the institutional review board at the Icahn School of Medicine at Mount Sinai in New York City. He holds an MD from Columbia University, a JD from Harvard Law School, and a bioethics MA from Albany Medical College.

Check out some of our past Ethics Consult cases:

Cut Health Insurance for Risky Activities?

Stop Life Support for a Tax Break?

Prescribe Pills Off-Label for Pilot’s Peak Performance?