In a case that was billed as profits versus patients, India’s Supreme Court dismissed a petition in which Roche sought to prevent a generic drug maker from selling a lower-cost version of a pricey rare disease medication.

The move came after a lower court earlier this month upheld a ruling that it would be in the public interest to allow Natco Pharma to sell a version of Evrysdi for about $179 a bottle. By comparison, Roche charges $6,982 for its drug, which is used to combat spinal muscular atrophy, a genetic disorder that causes certain muscles to become weak and waste away.  One severe form of the disease can lead to death by age 2 if left untreated.

Currently, more than 5,000 people in India are living with the disease and about 3,200 children are born each year with the condition, but fewer than 170 people accessed the drug a year ago, according to advocacy groups. The annual cost for an adult patient is $81,000, but while a patient assistance program exists, availability is restricted to what the Deli High Court recently described as a “minuscule” number of people.

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