Value regimes and pricing in the pharmaceutical industry: financial capital inflation (hepatitis C) versus innovation and production capital savings for malaria medicines

The idea of this paper is to draw a parallel between two diametrically opposed political economies of medicine that coexist today. The first is embodied in the invention, appropriation, and distribution of antivirals for hepatitis C, particularly sofosbuvir, which was commercialized at an initial price of $85,000 in the United States, €56,000 in France, and $8000 in Brazil. These prices destabilized payers in both the North and the South. The second economy encompasses the invention, industrialization and distribution of new therapeutic combinations for malaria that were commercialized by Sanofi from 2007 onwards at a price of $1 per treatment for public markets. This price was set by a contract negotiated with Médecins sans Frontières. In this paper, I examine the pricing of these 2 classes of drugs, and I argue that the prices synthesize these political economies: they summarize the policy of appropriation of these molecules, aimed at their monopolization or a model of common good; they are referred to economic value regimes designed to optimize the profitability of advanced capital or to increase the accessibility of drugs for public payers and patients; and they are justified or contested by moral economies.