The worldwide controversy over the pricing of Gilead’s hepatitis C drug Sovaldi has ramped up with a US Senate Finance Committee investigation concluding that the company put profit ahead of patients.

The investigation said that in 2014 state Medicaid programmes spent $1.3 billion before rebates to treat fewer than 2.4 percent of enrolees with hepatitis C. As a specific example, it noted that Indiana’s Medicaid programmes spent $40 million to treat 462 people.

Speaking at a press conference to announce the findings, Senator Ron Wyden said: ”It was always Gilead's plan to maximise revenue, and affordability and accessibility was an afterthought.

"If Gilead's approach to pricing is the future of how blockbuster drugs are launched, it will cost billions and billions of dollars to treat just a fraction of patients.”

The senators added that the prices of Sovaldi (sofosbuvir) and its follow up combo treatment Harvoni (ledipasvir-sofosbuvir) did not reflect the R&D or acquisitions costs related to the drug.

Sovaldi (ledipasvir-sofosbuvir) is able to effectively cure the vast majority of patients treated within 12 weeks. Its initial price in the US was $84,000 for a course of treatment. In the UK the drug costs £35,000 for a 12-week course.

In a statement Gilead countered: "With the rebates and discounts now in place, the prices today are less than the cost of prior regimens.” It added that Sovaldi reduces the long-term costs associated with chronic hepatitis C, such as the need for liver transplants. 

Harvoni was approved by NICE at the end of November in various different scenarios for patients with hepatitis C genotypes 1 and 4 at a cost of around £39,000 for a 12-week course and £78,000 for a 24-week one.