Gilead has authorized generic companies (primarily out of India -- think Dr. Reddy's, here), by license, to manufacture it -- and sell it -- but at an overall loss per patient -- for Gilead. It is simply not true that the new HIV med called Yeztugo® (lenacapavir) can be made today for under $40 per year of dosing. [Not for many years, yet -- into teh future, perhaps a decade on -- until all the cap ex to build out the plants has been recovered.]
Thus in some ways, the CVS CMO's position (and rhetoric) is. . . dishonest. She clearly knows what it takes to bring a new class of therapy on this scale (in a high burden disease) to market. And she well knows that it is humanitarian instincts that lead to developing world loss-leader pricing of $40 a year (which is still out of reach for much of those local populations) -- and that the involved companies are taking a real loss on it, to help humanitarian efforts in Africa, parts of India, Southeast Asia and Central and South America -- among other geographies.
And so, CVS as an entity is presently resisting pressure -- from AIDS patient activist groups, here in the US, to like-wise help absorb / cover some of the financial losses -- and list Gilead's Yeztugo at well-under the $28,000 retail quoted price. She may genuinely believe -- as many do -- that $28,000 is too much (allows for too rapid a recovery of invested cap ex at Gilead), but this sort of passing the buck. . . is essentially a form of unseemly attempted profiteering -- inside CVS. Blame-shifting helps. . . no one, least of all the patients in need of these therapies. And yes, there are now several alternatives on market in the US -- but mostly, this is proof of our broken, fragmented non-system for health care delivery in the US.
In any event, here's the latest:
. . .CVS Health has not added Yeztugo to its list of recommended PrEP therapies, but the company will cover alternatives, according to Gourdine.
“In increasingly crowded therapy classes of highly effective options, a generics-first policy remains the best approach for affordability and, by extension, health outcomes,” Guardine wrote. “We will continue to urge Gilead to lower the U.S. price for Yeztugo.”
The Centers for Disease Control and Prevention in September issued guidelines allowing twice-a-year injections for Yeztugo, and found near 100 percent effectiveness in trials for patients remaining HIV negative. Gilead has touted the drug as a major medical advance. . . .
Now you know -- and I'll leave for another day. . . a discussion of the possibility -- of an antitrust complaint -- (by Gilead) about a powerful distributor (CVS) trying to control retail prices, at a manufacturer (also, Gilead). Smile. Now. . . onward, grinning, with my eldest flying back in, from Istanbul, tomorrow. Woot!
नमस्ते
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