‘Right to Repair for Your Body’: The Rise of DIY, Pirated Medicine

Laufer is the chief spokesperson of Four Thieves Vinegar Collective, an anarchist collective that has spent the last few years teaching people how to make DIY versions of expensive pharmaceuticals at a tiny fraction of the cost. Four Thieves Vinegar Collective call what they do “right to repair for your body.”

Laufer has become well known for handing out DIY pills and medicines at hacking conferences, which include, for example, courses of the abortion drug misoprostol that can be manufactured for 89 cents (normal cost: $160) and which has become increasingly difficult to obtain in some states following the Supreme Court decision in Dobbs.

In our call, Laufer had just explained that Four Thieves’ had made some miscalculations as part of its latest project, to create instructions for replicating sofosbuvir (Sovaldi), a miracle drug that cures hepatitis C, which he planned to explain and reveal at the DEF CON hacking conference. Unlike many other drugs that treat viruses, Sovaldi does not suppress hepatitis C, a virus that kills roughly 250,000 people around the world each year. It cures it.

“The holy grail for every virologist is to find a way to drain the viral reservoir, and Sovaldi does this. You take one pill of Sovaldi a day for 12 weeks and then you don’t have hepatitis C anymore.” The problem is that those pills are under patent, and they cost $1,000 per pill.

“Literally, if you have $84,000 then hepatitis C is not your problem anymore,” Laufer said. “But given that there are other methodologies for managing hepatitis C that are not curing it and that are cheaper, insurance typically will not cover [Sovaldi]. And so we’ve got this incredible technology and it’s sitting on the shelf except for people who are ridiculously wealthy.”

So Four Thieves Vinegar Collective set out to teach people how to make their own version of Sovaldi. Chemists at the collective thought the DIY version would cost about $300 for the entire course of medication, or about $3.57 per pill. But they were wrong. “It’s actually just a little under $70 (83 cents per pill), which just kind of blew my mind when they finally showed me the results,” Laufer said. “I was like, can we do the math here again?”

A miracle drug called Kalydeco had recently been approved for use on some patients with cystic fibrosis. It cost $311,000 per patient, per year.

Laufer explains that both precursors needed to make Kalydeco are available commercially, and that one costs $1 per gram and the other costs $28 per gram. He checks the daily dosage (roughly 300 mg per day), and Chemhacktica spits out a potential yield. He explains that, in back-of-the-envelope math, “me, a non-chemist doing a first pass,” Kalydeco could be made “in the range of $10 a day for raw materials.” When Kalydeco was first introduced, it cost roughly $820 per patient per day.