In an attempt to get ahead of the curve, 14 Democratic members of Congress have written Gilead Sciences to caution the drugmaker to maintain a reasonable price for its forthcoming 'Quad' AIDS drug, a once-a-day treatment that was recently recommended by an FDA panel and may be approved by the agency this month. They express concern that Gilead may charge as much as $34,000 for Quad, which they say might contribute to further strain on state AIDS funding programs.
How so? They note that Gilead froze prices through 2013 for drugs provided to ADAPs, or AIDS Drug Assistance Programs, run by the states. But at the same time, the drugmaker boosted prices for its meds in the commercial market: a 7.9 percent increase on Truvadam, a 7.3 percent increase for Complera and a 6.6 percent increase on Atripla, which raises costs for privately insured and Medicare patients.
"As a result, Ryan White Part B programs that help these patients 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 ability of ADAPs to purchase drugs and sustain their case loads," they write to Gilead.
"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 ADAP and thousands of our most vulnerable constituents untreated. 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," they urge Gilead ceo John Martin (here is the letter).
They go on to maintain that, if Quad is priced between $27,000 and $34,000 per patient, this would represent a 38 percent premium above Atripla, another Gilead drug that is the most commonly used HIV combination treatement. And they expect Quad to become a widely used first-line therapy, since it consists of a single-tablet regimen and lacks neuropsychiatric side effects. Consequently, they calculate such pricing and usage would pressure ADAP programs.
As of August 9, there were 1,125 individuals on ADAP waiting lists in seven states, according to the National Alliance of State & Territorial AIDS Directors. This is a 63 percent drop from April. Nonetheless, 21 ADAPs, including seven with current waiting lists, have instituted additional cost-cutting steps over the past three years and two ADAPs are considering new or additional measures by March 2013 (read here).
A Gilead spokeswoman declined to comment on the pricing, since the drug is not yet commercially available. If approved by the FDA, the Quad treatment would be used by people living with HIV who are starting treatment for the first time. The drug actually includes four medications - Viread; Emtriva; an experimental integrase inhibitor known as elvitegravir, and cobicistat, which is actually not an HIV medication, but can boost the utility of elvitegravir.
One advocacy group praised the move to draw attention to pricing even before the drug is available. “It would be unconscionable but, sadly, not entirely unexpected, if Gilead priced the Quad higher than similar drugs already on the market, particularly when the Quad is only a marginal improvement over other existing medications," says AIDS Healthcare Foundation president Michael Weinstein, in a statement. "In the long run, the cost to Gilead to actually produce the Quad will be a small fraction of its selling price, which means Gilead can show restraint on Quad pricing and still make an enormous profit.”
8 Comments
At some point we do need to ask? Is healthcare just another business to be in? Or do the people accessing these drugs really matter? I'd also like to add that the mega non profit organizations out there doing testing and providing treatment. You can't "Cry wolf" so to speak to drug companies while you restructure your infrastructure to make more profit.
If you expect the drug companies to have compassion, and remember that there are people involved with there efforts to control this disease. We EXPECT the same from YOU!!!!!
At some point, not too far off in time, btw, because of the population curve, the realization will occur that quarantine has to be brought back into the mix in managing the affliction. And mandatory quarantine never is pretty. So why wait until it gets dire? Make a better effort at self-policing.
Before everyone's PC hair sets on fire, go ahead and crunch the numbers to see how many resources are needed for a population of 9 billion...and then tell me how much more Middle Class (er, global slave class) "austerity" will suffice?
I am also a disciple of Dr Paul Ehrich, whose solution came from the opposite end of the telescope. Ehrlich's book "The Population Bomb" suggested that we solve the problem by limiting population growth until equilibrium with the death rate was achieved. This led to the concept of Zero Population Growth, and in the 40 years or so since it's publication the number of children born to white families has been reduced by almost one full child. In advanced countries such as in western europe and Japan the strategy has been succesful to the extent that the birth rate can't keep up with the death rate. And of course, the country with the fastest rising GDP in past 20 years, China has a restrictive policy on number of births/family.
Thus if you are a true believer in Malthusian principles it makes no sense for society to pay $28,000/year, or even one thin dime to keep AIDS patients alive.
Guess I can set some hair on fire as well.
because then the human species would become even more psychotic than it already is thanks to modern warfare techniques like rounding up the intelligensia and shooting them in the head in front of the ditch they just dug.
It is clear that there will always be some retrograde bacteria to pop up and threaten the species down the road, anyway. Best to keep the science chops focused on cures rather than chem/bio weapons. Life is tough enough, thanks.
And as you note, normal-minded people can manage the situation with their own free will cooperation once they know what that comfortable and stable man to land ratio is for their neck of the woods.
But quarantine must be part of the management until the cure is found. Otherwise someone might think that increasing the quantity of people infected will induce someone else to find the cure faster. Threats and fear and more money...? Not the magic formula so far....
Here's where I'd stash them:
http://www.knowla.org/entry.php?rec=576