August 26, 2012

August 26, 2012
Congress Urges Reasonable Price for Gilead’s Quad

Welcome to another day in my life. Today is Sunday and I hope you are having a safe and great weekend so far. It is another busy weekend for Dab the AIDS Bear and me. The bear is at events in four different cities in two countries so stay tuned for more pics and slide shows soon.

Fourteen members of Congress are urging Gilead Sciences to maintain a reasonable price for its soon to be approved “Quad” containing elvitegravir, cobicistat, tenofovir and emtricitabine, according to an August 1 letter sent to the Foster City, California-based drugmaker.

The congressional lawmakers are concerned that Gilead will charge as much as $34,000 for the fixed dose combination tablet, putting additional strain on state AIDS Drug Assistance Programs (ADAPs). This price, they note, would be 38 percent more than the cost of Atripla and would have a detrimental impact on ADAP, as purchasing drugs represents 85 percent of its costs. The letter concludes:

“It is our sincere hope that Gilead will support our nation’s ADAP by considering sustainable HIV/AIDS drug pricing in the commercial market particularly for the Quad—as well as supplemental price reductions and rebates, that bolster the ability of ADAPs nationwide to provide lifesaving drugs to all those in need."

The following is the letter sent to Gilead from the Members of Congress:

"Dear Dr. Martin:

As members of Congress who are committed to ensuring access for people living with HIV and AIDS to lifesaving treatment, we write to express our concern regarding the implications of Gilead's recent price increases for certain antiretroviral drugs in the commercial market on our nations AIDS Drug Assistance Program (ADAP). It is our understanding that, while Gilead currently has a price freeze and effect through 2013 for drugs provided to ADAP, the prices of HIV/AIDS drugs in the commercial market have indirectly exacerbated the ongoing ADAP funding crisis. In in addition, we are troubled by media reports that indicate they Gilead made charges much is $34,000 for its new drug, known as the "QUAD" in the commercial market. Without more affordable HIV/AIDS drugs, we fear that Ryan White Part B funded co-pays and deductibles will continue to rise, leaving less funding available for a dab and thousands of her most vulnerable constituents and treated. Therefore, we urge Gilead to consider sustainable pricing strategies for its products that would help allow ADAP to provide treatment to as many individuals as possible.

In January, Gilead imposed a 7.9% price increase on Truvada and agreed to a 7.3% increase on Complera and a 6.6% increase on Atripla in the commercial market. These price increases significantly exceed the annual rate of inflation according to the Consumer Price Index (CPI), making these drugs less affordable for privately insured patients and Medicare patients. As a result, Ryan White Part B programs that help these individuals afford their co-pays and deductibles now face overwhelming demand and have instituted waiting lists. Given that Ryan White part B funds both the co-pays and deductibles of privately insured patients as well as ADAP, price increases for antiretroviral drugs in the commercial market diminish the abilities of ADAPs to purchase drugs and sustain their case loads. More affordable prices for antiretroviral drugs in the commercial market would mean smaller co-pays and deductibles for insured patients and thus more Ryan White Part B funding for ADAP.

Furthermore, several leading national AIDS organizations have indicated that, based on their analysis of the current market price of antiretroviral components, they expect Gilead's upcoming Quad HIV combination drug to cost between $27,000 and $34,000 per patient per year. This would be 38% more than the cost of Atripla, the most commonly utilized HIV combination drug. Due to the Quad's single tablet regimen and lack of neuropsychiatric side effects, it is expected to become a first-line therapy for many doctors. Yet if the Quad is commercially priced at the lowest estimation of $27,000, the negotiated price for ADAP will still likely top the current ADAP price for Atripla of $10,000 per person per year. This would have a detrimental impact on ADAP as purchasing drugs, who represents 85% of its costs. Current ADAP funds would equate to fewer drugs per patience and waiting list would grow.

ADAPs around the country are already struggling to meet the increasing demand for HIV/AIDS drugs. According to the most recent data available, there are 1,805 individuals on ADAP waiting lists in nine states nationwide. Furthermore, 445 individuals in three states were disenrolled from their respective programs as a result of new cost-containment measures and 6 ADAPs have lower their financial eligibility. Given the difficult budget challenges facing the states, rising drug costs in the commercial market threaten to further hinder ADAP operations and disrupt or prevent access to life-saving treatments for those in need. Previous drug price increases and the commercial market that exceed the annual rate of inflation have forced states to either cut funding for ADAP or other essential healthcare services. In the end, people living with HIV/AIDS are paying for these costs with their health.

At the time when millions of Americans continued to face daily uncertainties – from diminishing job security and income, to devalued mortgages, to rising healthcare costs – people living with HIV/AIDS are especially vulnerable. For the majority of these individuals, who are low income, uninsured, or underinsured, ADAP is their only lifeline. Sadly, due to the ongoing ADAP waiting lists, reduce formularies, and other cost-containment measures, countless individuals living with HIV/AIDS do not know where else to turn for the drugs they need to stay alive. In this regard, we would like to commend Gilead and other pharmaceutical companies for their efforts to help these patients through it ADAP rebates and their co-pay and Patient Assistance Programs (PAPs). Alternately, however, we cannot hope to bring an end to the waiting list if ADAP is unable to procure the drugs necessary to support all patients using current available funding.

If we are to be successful in improving the health outcomes of people living with HIV/AIDS and preventing the transmission of HIV, we must strive to make treatment more accessible and affordable for all patients. The rising cost of antiretroviral drugs in the commercial market have limited the number of people who can be serve using the existing ADAP funds, which, despite increased support in recent years, have proven to be severely insufficient. The unfortunate reality is that many state ADAPs are just one budget crisis away from exhausting all available funds. In fact, this scenario has already come to pass. Moreover, while ADAP serves as a safety net for low income, uninsured, and underinsured individuals, those who do not meet increasingly tougher income eligibility requirements are potentially faced with paying full price for their drugs.

Mr. Martin, thank you for your attention to this important matter. We greatly appreciate Gilead's continued commitment to developing new, more efficient strokes for people living with HIV/AIDS. For over two decades, Gilead has been at the heart of advancing the health of the HIV/AIDS community. It is our sincere hope that Gilead will support our nations ADAP by considering sustainable HIV/AIDS drug pricing in the commercial market – particularly for the Quad –, as well as supplemental pricing reductions in rebates, that bolster the ability of ADAPs nationwide to provide life-saving drugs to all those in need. Thousands of people living with HIV/AIDS are depending on it. If you should have any questions, or if we may be of any assistance, please do not hesitate to contact us.


Alcee L. Hastings Member of Congress


Well that's the end of the message from Congress to Gilead. Now you know the rest of the story. hopefully, fair pricing can be determined to help everyone in our country trying to live with HIV and AIDS.

I hope you have a very safe and great Sunday.

Until we meet again, here's wishing you health, hope, happiness and just enough.

Big bear hug,

Daddy Dab