Why one Drug Company is Donating its HIV Prevention Drug to 200,000 Uninsured Americans

Gilead Sciences, the drug company behind the groundbreaking HIV prevention drug known as Truvada or PrEP, has reached an agreement with the Trump White House to donate PrEP to up to 200,000 uninsured people a year.

PrEP has demonstrated a remarkable ability to cut HIV-1 infection risk in at-risk groups, if users take the drug on a daily basis. It does not replace the need for condoms, which can protect from other STIs, but it has proved particularly useful for preventing the spread of HIV among groups like men who have sex with men, sex workers and other people who engage in so-called “high risk” sexual behaviors.

However, despite its 70-90 percent effectiveness, PrEP’s availability has been compromised by two major things:

  1. a lack of awareness that PrEP is available and is a critically important part of the HIV-prevention strategy
  2. its price.

PrEP, under its brand name Truvada, can cost as much as $20,000 per year. The price of Truvada has steadily climbed since it first hit the market as an HIV prevention strategy in around 2004 and then later approved as a PrEP method in 2012.

Gilead’s donation program, which will run for at least the next 11 years, could help improve availability and break down that cost barrier.

“We are proud to partner with CDC to dramatically expand access to medication that can help prevent new HIV infections,” Gregg Alton, Chief Patient Officer at Gilead Sciences, said in a press statement. “We believe today’s donation, combined with efforts to address the root causes of the epidemic, such as racism, violence against women, stigma, homophobia and transphobia, can play an important role in ending the HIV epidemic in the United States, particularly in parts of the country with the highest burden of disease.”

However, some health advocates have said that while any increase in PrEP availability is welcome, this doesn’t do much to close the massive shortfall in availability.

Jen Kates, the director of global health and HIV policy at the Kaiser Family Foundation, put this in perspective on Twitter:

Critics of Gilead say that if the company really wanted to help, it could slash the price of Truvada or the company’s new offering, Descovy.

The New York Times summarizes these feelings neatly, saying: ”Gilead appears to be following a pattern set in 2001 by other drug companies. While millions of Africans died of AIDS because their drugs cost as much as $20,000 a year, drug makers refused to cut their overall prices. … The tactic ultimately failed, and Indian companies now supply almost all of Africa’s H.I.V. drugs. In Africa, generic Truvada is sold for about $60 a year.”

The fear here is that Gilead is using the positive press from this donation to ease in its change to Descovy once Truvada’s patent is up.

Yet to be approved, Descovy is said to be just as effective as Truvada but with fewer side-effects. Critics charge that this donation program would essentially allow Gilead to switch its Truvada base to Descovy without a real-world impact on the company’s global PrEP profits, which stand at somewhere around $3 billion. This effort, critics argue, would also effectively torpedo generic Truvada by pushing the (presumably) better Descovy in clinics and making it the go-to among insurers. Essentially, it is Gilead trying to keep its grip on HIV patients’ wallets.

It is critical, however, that we put this in focus: any increase in availability for the drug is a significant win for preventing HIV, because it starts to close down the pathways by which HIV might spread. Furthermore, it is easy to be cynical about drug companies’ motivations given how much we know about prior price gouging activities.

However, as other activists have pointed out, the companies are working within a system that positively encourages growing profits in order to keep innovating—and the pressure for new and better drugs is always on. It is the system, therefore, that needs reform with strict checks to ensure that people, not profits, are put first.

Meanwhile, the federal government has praised Gilead’s actions as an important step in the Trump White House’s efforts to end HIV by 2030.

Of course, this all becomes academic if—under the chasm-wide religious exemptions the Trump administration is carving in civil rights laws—insurers, clinicians and even doctors can refuse to treat people who are most in need of PrEP for vague and biased “religious reasons”.

Photo credit: Getty Images.

40 comments

Lizzy Q
Lizzy Q2 hours ago

many thanks

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Lizzy Q
Lizzy Q2 hours ago

many thanks

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Chad Anderson
Chad Anderson14 days ago

Thank you.

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hELEN h
hELEN hEARFIELD17 days ago

tyfs

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Hannah A
Hannah A19 days ago

very good

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Doris F
Doris F19 days ago

@C2...what happens with C2 ?????
All actions are break down ! hmmmpfff :-(

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Daniel N
John N24 days ago

thanks for posting

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RK R
RK R27 days ago

Waiting for the number crunch to prove HIV prevention drugs indeed prevent HIV. Test Lab donations are still better than none.

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Joan E
Joan E27 days ago

Glad to see someone is sane and decent.

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Lisa M
Lisa M28 days ago

Thanks.

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