Gilead to donate HIV drug to US government prophylaxis scheme

Gilead has announced it will donate its HIV drug Truvada to a US-government led prophylaxis programme to end the epidemic of the disease.

Truvada (emtricitabine+tenofovir disoproxil fumarate) is indicated in the US as a prophylactic treatment that can help prevent uninfected but high-risk individuals from contracting the disease in combination with safe sex.

President Trump announced an ambitious plan to end the HIV epidemic during his State of the Union address in February, with wider access to pre-exposure prophylaxis (PrEP) being an important part of the programme.

Following this, Gilead has said it will donate up to 2.4 million bottles of Truvada annually to the US Centers for Disease Control and Prevention (CDC) for use by uninsured Americans at risk of the disease.

The donation, which lasts until 2030, will transition to Descovy (emtricitabine+tenofovir alafenamide) if it is approved for use as PrEP, Gilead’s proposed follow-up PrEP drug that has fewer side-effects.

Truvada is considered safe but can cause kidney problems and loss of bone density in some cases, while Descovy has fewer of those effects although it does raise cholesterol levels more than Truvada.

At the moment only 200,000 of the estimated 1.1 million Americans considered at risk for HIV currently receive Truvada for PrEP.

Gilead said broader use is hampered by social and structural barriers – HIV stigma, homophobia, limited awareness of PrEP among providers and patients, lack of access to healthcare.

However some commentators suggested that this is a shrewd marketing tactic on the part of Gilead, allowing it to raise awareness of Descovy ahead of any approval.

Trial results announced in early March show Descovy matched Truvada's effectiveness at preventing infection, and Gilead has said it plans to file the drug with regulators as a result.

Dr Rochelle Walensky, from Massachusetts General Hospital, an expert who analysed costs of the Obama administration’s AIDS plan told the New York Times that the deal “covers less than 20% of the people who need it.”

She added: “If I put on my cynical hat, I think this is the way they (Gilead) make sure they grow the market for Descovy.

“It will promote the idea that Descovy is better - and I’m not sure that’s a dialogue we want to present.”