It’s a pill that cures hepatitis C in 9 out of 10 patients, leading medical societies to recommend it as the first line of treatment against the illness. The catch of Sovaldi, a new pill for hepatitis C, is its price tag: $1000 for a pill, with treatment costs ballooning up to $90,000, according to an Associated Press report.

“People are going to want to try to dodge this hot potato,” says economist Douglas Holtz-Eakin.

The “hot potato” in question is the cost versus the benefit of Sovaldi, as insurance companies and state Medicaid programs are struggling with the price. In Oregon, officials are proposing to limit the amount of low-income people that can get Sovaldi.

Still, for many with hepatitis C, an illness that killed 15,000 in 2007 when it surpassed AIDS as a cause of death, the pill provides a much-needed relief from other treatments that cost five-figures anyway and cause debilitating side effects.

Before the pill’s approval last year, standard treatment for the most common form of hepatitis C included daily pills and extended use of interferon, an injection that causes flu-like symptoms. With Savoldi, the length needed for interferon is lowered, making treatment more tolerable for patients.

“If it’s going to get me the medicine, I’ll put my hand out there with a tin cup,” Stuart Rose, a hepatitis C patient in New York City, told the Associated Press.

More than 3 million Americans carry the hepatitis C virus, and many are not aware of it. It’s a disease that can be transmitted via infected blood and sometimes through sexual activity. It progresses gradually and can destroy the liver, with transplants averaging $577,000.

Drug maker Gilead Sciences, Inc., reported sales of Sovaldi of $2.3 billion worldwide in just the first three months of the year, because the drug’s high cure rate makes it a “a real huge value,” vice president Gregg Alton told the Associated Press.

In many countries, governments set drug prices. In the U.S., insurance companies are left to negotiate with drug companies, with Medicare forbidden from bargaining. This, some say, saddles the U.S. with high drug costs, leading to the situations like with Sovaldi.

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