The median (IQR) proportion of fills with a coupon was 70.0% (33.3%-100.0%), and many patients discontinued the drug after the last coupon. Coupons were used for a median (IQR) of 3 (2-6) fills. Approximately two-thirds of treatment episodes (24 351 episodes ) used a coupon for the incident fill. Among these episodes, nearly all instances (35 103 episodes ) of first coupon use occurred within the first 4 prescription fills. The statements, findings, conclusions, views, and opinions contained and expressed herein are not necessarily those of IQVIA, Inc, or any of its affiliated or subsidiary entities.Ī total of 36 951 treatment episodes accounted for 238 474 drug claims and 35 352 unique patients (mean age, 48.1 years 17 676 women ).
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Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study collection, management, analysis, and interpretation of the data preparation, review, or approval of the manuscript and decision to submit the manuscript for publication.ĭata Sharing Statement: See Supplement 2.ĭisclaimer: The statements, findings, conclusions, views, and opinions contained and expressed in this article are based in part on data obtained under license from the following IQVIA information service(s): Formulary Impact Analyzer, IQVIA. No other disclosures were reported.įunding/Support: This work was supported in part by the John and Laura Arnold Foundation and by grant T32HS000029 from the Agency for Healthcare Research and Quality. These arrangements have been reviewed and approved by Johns Hopkins University in accordance with its conflict-of-interest policies.
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Corresponding Author: So-Yeon Kang, PhD, MBA, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Hampton House 428, Baltimore, MD 21205 ( Contributions: Dr Kang and Ms Liu had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.Īcquisition, analysis, or interpretation of data: All authors.Ĭritical revision of the manuscript for important intellectual content: All authors.Īdministrative, technical, or material support: Kang.Ĭonflict of Interest Disclosures: Dr Alexander reported being past Chair of the US Food and Drug Administration’s Peripheral and Central Nervous System Advisory Committee a cofounding principal and equity holder in Monument Analytics, a health care consultancy whose clients include the life sciences industry as well as plaintiffs in opioid litigation, for whom he has served as a paid expert witness and a past member of OptumRx’s National P&T Committee.
Birch Bayh, D-Ind., and Robert Dole, R-Kan., argued in 2002 that pricing was deliberately not conceived as one such circumstance. The 1980 Bayh-Dole Act, though, allows private grabs of public science the government can claw patents back under certain circumstances, but Sen. (Until Teva’s generic debuted, Gilead owned 100 percent of the Truvada market in the U.S, pulling in roughly $3 billion a year.)īut the basic research, animal trials and human trials for the combination of the two as preventative drug were all publicly financed by the National Institutes of Health and the Centers for Disease Control and Prevention. To get it, we can't rely on corporationsĮmtricitabine, the second drug in Truvada and its generic equivalents, was developed at Emory University with NIH grants Emory then entered into an agreement with a company Gilead eventually acquired to give it control of the drug in exchange for a sliver of the profits. Opinion To recover from COVID-19, America needs a vaccine.
Meanwhile, generic versions of Truvada - Ricovir, Tavin-EM, or Tenof-EM - elsewhere in the world cost $210 to $720 per year.
Unfortunately, California and Massachusetts both forbid the use of pharmacological coupons that made Truvada somewhat accessible if a generic alternative exists patients who relied on those discounts must now apply for access to other programs or pay out of pocket for the medications they couldn't afford. Teva's patient discounts are also $7,200 per year, but they’re limited to $600 per month - knocking its monthly cost down to around $855.
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Gilead provides some patients a coupon for $7,200 worth of purchasing assistance per year, with no monthly limit (which means some months it might be free and others it might be full price). Insurance, for those who have it, helps lower out-of-pocket costs in many cases, though private insurers aren't required to do so until 2021. Of course, few people pay the full price of a medicine out-of-pocket. Gilead's all-but-proprietary access to sell Truvada is the equivalent of Hershey’s controlling who has access to chocolate milk.
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