The company that makes Truvada, the only drug on the market that can prevent HIV, has announced plans to donate enough to supply 200,000 patients for 11 years, federal health officials said on Thursday.
But the response was mixed, as activists and experts say this will only address about 20% of the population who needs access to this drug, which costs a staggering $20,000 a year. Activists say its high price has made it out of reach to low-income Americans, which is one of the reasons the AIDS epidemic persists, the New York Times reports.
“Securing this commitment is a major step in the Trump administration’s efforts to use the prevention and treatment tools we have to end the HIV epidemic in America by 2030,” Health and Human Services Secretary Alex M. Azar II said in a statement announcing the news. President Trump said at his 2019 State of the Union that it was a goal of his administration to end the HIV epidemic in the US within 10 years.
Truvada, which is also known as PrEP, is taken once a day to prevent HIV infection. The Times says that 1 million Americans are at risk of getting the disease, but only about 270,000 are currently taking the medication.
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Critics asked why Gilead, the company that makes the drug, was not instead cutting its price to allow everyone access. In African countries, a generic version of Truvada costs $60 a year.
The Times detailed how Gilead’s decision to donate limited quantities of the drug instead of lowering its price overall follows in the footsteps of other drug companies that, in 2001, offered to donate doses of the drug while simultaneously pressuring United States and European governments to ban the import of of generic versions from India.
Millions of people across the African continent died of AIDS as a result of not being able to afford $20,000 annually for drugs, which are now supplied from India for a fraction of the cost.
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Gilead has sued companies in the United States to keep generic versions of Truvada from entering the market. It plans to release its own generic version of Truvada next year, and also a new HIV prevention drug, Descovy, which will also cost $20,000 a year.
Dr. Rochelle P. Walensky, who has analyzed the costs of the Obama and Trump administrations’ AIDS plans, called the deal “a noble effort but it covers less than 20% of the people who need it.”
“Let’s call a spade a spade,” Walensky told the Times. “The real cost of Truvada is about $60 a year. If you really wanted to cover everybody, you’d cut the price to everyone. If I put on my cynical hat, I think this is the way they make sure they grow the market for Descovy. It will promote the idea that Descovy is better — and I’m not sure that’s a dialogue we want to present.”
Truvada is considered safe, but can increase the risk of kidney problems and bone density loss. Descovy is less likely to cause those side effects, although it may raise cholesterol levels.
Peter Staley, who co-founded PrEP4All, which promotes access to the drug, told the Times that the donation was “promising but depressing” given how little it costs Gilead to make each year.
“We know Truvada costs $4 a bottle to make, so this donation costs them only $9.6 million a yr. But no lowered price, so they keep selling $3 BILLION of Truvada a year!” Staley wrote on Facebook. “This won’t cut into Gilead’s sales at all, and it’s a very cheap marketing program for Descovy.”
It's unclear exactly how the donated PrEP will be distributed, and to whom. Gilead did not immediately respond to Global Citizen’s request for comment.
The company is under investigation by the Department of Justice over allegations that it did not pay the Centers for Disease Control and Prevention for its contribution to creating Truvada.
“This shows you the inherent shell game in pharmaceutical pricing,” Mitchell Warren, the executive director of AIDS-prevention organization AVAC, told the Times. “We urgently need a lower price, and it’s disappointing that even this has taken so long.”