Ohio War on HIV Watch: Is Gilead really being all that charitable with anti-HIV meds?

As previously noted, the Trump administration is moving to combat the HIV epidemic, which has become especially bad in Ohio. This matters a lot because while Ohio doesn’t look like it will be a swing state in 2020, in practice it could be if issues tied to the opioid crisis are not brought under control and truly combated.

The Trump administration is already at work combating HIV here and elsewhere where higher use of injectable drugs has kicked off an epidemic. One effort involves leveraging the existing 340B drug discount program to get Truvada– anti-HIV medication– to the less well-off, more vulnerable populations that need it. Another involves Trump’s continued use of the bully pulpit to try to force drug prices down. As a reminder, this matters a lot because Truvada can retail for $20,000 for a year’s treatment.

The former approach relies on an already well-established program that entails nothing “new” to be done, other than for providers in the 340B program to get Truvada into exposed people. The latter, however, entails getting Gilead Sciences, the maker of Truvada, to actually drop its prices or get charitable fast. So of course, people tracking this issue were delighted to see news earlier this month that Gilead Sciences had announced it would donate enough doses of Truvada to cover up to 200,000 people for the next 11 years.

But is it really good news? Or at least wholly good news?

Washington DC publication Axios noted in a newsletter that Gilead has a new anti-HIV drug that’s almost ready to hit the market, Descovy, and it appears that generic versions of Truvada are also forthcoming. That makes the drug giant’s move seem less charitable and more… self-serving.

Donated Truvada will apparently only be available for uninsured patients, and not those on Medicaid or Medicare. And by limiting the “donated” Truvada this way, Gilead is potentially ensuring massive demand for Descovy– or such is the view of Massachusetts General Hospital’s Rochelle Walensky who was quoted by the New York Times.

Gilead is also one of the biggest corporate opponents of the 340B program and has been working to curtail it for years. If it were to succeed, that would further limit access to Truvada. The upshot being that while President Trump deserves credit for what his administration is doing to combat HIV, it’s possible the most important drugmaker in the space is still playing games to try to build a market for themselves while limiting access for existing, vulnerable populations.

It’s also worth remembering that Joe Grogan, a former Gilead lobbyist, occupies a particularly important office in the. administration where drug pricing is concerned. That could facilitate Trump getting the message to Gilead more quickly that this charitable move is good, but not enough, or alternatively lead to Gilead having greater insight into how to work around Trump to achieve their objectives while stifling the President’s work.