Cost of Gilead's Truvada has hindered HIV prevention, analysis finds

The rising cost of Gilead's Truvada may be a key factor in why the HIV prevention drug has not been widely used, according to an analysis published in the Annals of Internal Medicine

Truvada, also known as PrEP for pre-exposure prophylaxis, was approved in 2012 and is the only approved HIV prevention pill on the market. 

Gilead, the company that makes Truvada, has raised the cost of the drug over the years and has been accused by AIDS activists of overcharging, according to STAT

From 2014 to 2018, total payments made by government programs, commercial insurers and patients for Truvada increased from $114 million to nearly $2.1 billion, the CDC-funded analysis found. But the number of people given prescriptions for Truvada in 2018 was just 204,700, less than 20 percent of the people estimated to benefit from the medication. 

Patients have also taken on more of the cost burden for Truvada during that time period. Average out-of-pocket costs have risen from $54 to $94, an annual compound growth of 15 percent. But the overall cost of 30 tablets rose from $1,350 to $1,638, a 5 percent compounded annual growth rate. 

"Despite the high effectiveness of [the HIV prevention pill], uptake remains suboptimal, especially among populations most affected by HIV," the study's researchers wrote. They also said "high costs to the healthcare system may hinder expansion." 

Gilead has defended its pricing of the drug and said it has patient assistance programs to help patients pay, STAT reported. But CDC researchers said those programs accounted for only 6 percent of total payments for the drug in 2018. 

The study did have limitations. The researchers studied a prescription database run by market research firm IQVIA, which captures about 92 percent of all prescriptions dispensed by retail and commercial pharmacies, according to STAT. But it doesn't have data involving prescriptions from governments systems or closed insurance systems. 

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