For the second time in recent months, California State Controller John Chiang has written a drugmaker asking for a reduction in the price of a key AIDS med. This time, Chiang wrote Gilead Sciences to lower the price of its Atripla drug, which costs about $21,900 a year per patient and accounts for about 20 percent of all expenditures made by the AIDS Drug Assistance Programs (ADAP) nationally.
The move comes amid shrinking budgets for state ADAP programs (back story) and nearly a dozen states maintain growing waiting lists that, cumulatively, number more than 7,200 people, according to the National Alliance of State & Territorial AIDS Directors (see this). And Chiang maintains California can no longer keep up with rising demand and rising prices, according to his letter.
Specifically, California’s ADAP program has experienced a 257 percent increase in AIDS drug spending since 2000, more than three times the rate of client growth over this same period, Chiang writes Gilead. The state is "faced with either racheting down access to ADAP or cutting other vital health services to offset the cost of ADAP," he writes, adding that supplemental agreements with several drugmakers expire this year, adding to the financial pressures (read the letter).
"I urge you to extend the supplemental agreement you already have in place with the state and provide additional pricing considerations that will translate into a cost savings for the program. Only by a shared responsibility to sustain this program can we ensure ADAP will serve all the people who rely on it," according to his letter. We have asked a Gilead spokeswoman for a comment and will update you accordingly.
And in imploring Gilead to strike a balance between profits needed to generate further research and patient access to life-saving meds, Chiang not too subtly notes that he a board member of both the California Public Employees’ Retirement System and the California State Teachers’ Retirement System, which are two of the largest public pension funds and also "substantial shareholders" in Gilead. Last summer, Chiang took a simliar approach in pressuring Bristol-Myers Squibb to lower the cost of its Reyataz AIDS med (read here).
UPDATE: A Gilead spokeswoman wrote us to say that "what we can say at this point is that we are very concerned about and committed to patient access to our medications - this is an important issue and one we take very seriously. There are a few inaccuracies in the letter with respect to Gilead's commitment to programs to help ensure access and we have reached out to the Controller's office. We are hoping to arrange a meeting in the near future to discuss specifics."