When I have a cup of water, I can put out a stove fire. But I can't put out a forest fire even if the water is 100% strong.
Therefore everyone has to wear a mask. As a nation, we will recover faster if you give the vaccine less work when it's ready.
– Rochelle Walensky, MD, MPH (@RWalensky) December 8, 2020
Walensky testified before Congress last May about the exorbitant cost of drugs to treat HIV. She said the sale of Truvada, which is used to treat and prevent HIV, resulted in $ 36 billion in profits and has seen its price increase 150% since 2004. “Less than 150,000 have ever received it. Over 75% of them are white gay men in the northeast and west coast, ”she said. However, the population most affected are black gay men, and it was estimated in 2016 that one in two of them will be diagnosed with HIV at some point in their life. Pharmaceutical companies have "already benefited tremendously," said Walensky. "Now in the spirit of saving lives, preventing new infections, making public health a reality, developing a coherent public health response and making a presidential call to action a reality," she added, "I just urge these Medicines are reasonably priced so that those who are most marginalized at this risk can benefit from them. "
Walensky's full speech:
"My name is Dr. Rochelle Walensky. I am a professor of medicine at Harvard Medical School, director of the infectious diseases division at Massachusetts General Hospital, practicing clinician, and researcher on the cost-effectiveness of HIV care in the US and internationally. In 1995, we AIDS patients said they would surely die. AIDS plagued my internship. At the end of the year we had an FDA cleared HIV cocktail. Three drugs, up to 14 tablets a day, that made life possible for AIDS patients when taken strictly. At the time, the three drugs in the cocktail totaled $ 15,000 per person per year, and our research team reported the cost-effectiveness. We have shown that for many it is good value for money.
Today we definitely have the means to end this epidemic. The HIV three-drug cocktail known as antiretroviral therapy is often combined into a single daily pill. The regimes have high resistance barriers. It's good. They have and low toxicity profiles. That is good too, and prognoses suggest normal life expectancy for adherent HIV patients. We also know that people who take these drugs and effectively suppress their virus cannot pass it on to others. But the cost of these drugs today is $ 40 to $ 50,000 per person per year. An increase of 300% in 25 years.
Truvada is a co-formulation of two of these three drugs used for treatment, scientifically known as a combination of tenofovir disoproxil fumarate and Emtricitabine. It was approved by the FDA for HIV treatment in August 2004 and has been a mainstay of HIV care ever since. After notable scientific work, much of it by Dr. (Robert) Grant, the FDA approved the extended indication for Truvada in 2012 Pre-exposure prophylaxis or PrEP, for HIV prevention. The cost of Truvada upon FDA approval in 2004 was $ 7,800 per year. Today it costs $ 20,000 a year. A similar combination of drugs is available internationally at a cost of $ 60 per year. Please understand I am not suggesting that this be the US price. I am simply offering this national pricing benchmark to put in a global context.
In his February State of the Union Address, the President announced his initiative to end the HIV epidemic. It won't be easy. The benchmarks for the Ending Epidemic Initiative are a 75% decrease in the number of new HIV infections in five years and a 90% decrease by 2030. Our research group has published work highlighting that even if we are 90% of the people diagnosed, treated and virologically suppressed with HIV, we can only reduce the number of new infections by 40%. In short, to end this epidemic we need both treatment and prevention. In addition to treatment, PrEP offers the most effective known preventive measure.
Make no mistake, even if it was free, PrEP is difficult. In addition to medication compliance, quarterly doctor visits are required for HIV testing, sexually transmitted infection screening, and laboratory monitoring. Right now, however, the biggest problem with PrEP is access. The CDC estimates that more than 1.1 million people in the United States are at high enough risk of HIV to warrant preparation. Less than 150,000 have ever received it. Over 75% of these are white gay men in the northeast and west coast. But today's uncontrolled HIV epidemic is widespread among black gay men and continues to disproportionately affect women of skin color, especially in the south.
In 2016 it was estimated that one in two black gay men will be diagnosed with HIV in his lifetime. We need prevention tools like PrEP to reach these marginalized populations if we are ever to contain the epidemic without achieving the benevolent goals for ending the epidemic. The Truvada sale resulted in a profit of $ 36 billion, and Truvada has continued to see price increases of 150% since 2004. That price is just too high.
We have the scientific resources to end this HIV epidemic, and we are fortunate that Pharma developed these drugs to get us there. You have already benefited enormously. In order to save lives, prevent new infections, achieve public health, implement a coherent public health response, and implement a call for action from the President, I simply ask that these drugs are reasonably priced so that they can The most marginalized people at risk may reap their benefits. Finally, I should like to welcome Congress for holding this hearing and for bringing this issue to the fore in public dialogue. I hope some of these companies, including Gilead, will start doing the right thing. It's never too late for that. "
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