Alexandria Ocasio-Cortez Takes on Truvada in Congress

This morning, Congress met with medical professionals, activists, and the CEO of Gilead, Daniel O’Day, to examine Gilead’s pricing for Truvada, the only FDA-approved drug to be used as PrEP.

The hearing, which was streamed live on C-Span, examined taxpayer funding that led to its approval and whether the public is receiving an appropriate return on its investment.

Though approved in 2012 to be used as PrEP, a prevention strategy that when taken accordingly makes it virtually impossible to contract HIV, Truvada is sold for nearly $2,000 per month and, last year, generated $3 billion in revenue for Gilead worldwide.

But according to BreakThePatent.org, it costs Gilead only $6 to make. As Alexandria Ocasio-Cortez pointed out in the hearing, countries like Australia sell generic versions of Truvada for only $8. 

Organizers at PrEP4All, the organization behind #BreakThePatent, fights for full access to PrEP for anyone who needs it. They were the lead voices behind a report in The Washington Post, published in March, detailing that the federal government issued $50 million in grants to researchers developing PrEP. That money comes from the tax payers. PrEP4All claims that in 2015, the Centers for Disease Control and Prevention patented the use of Truvada as PrEP. However, Gilead has reaped all the profits and allegedly have not paid back a dime to the CDC in royalties.

O’Day told Congress that the patent on Truvada for PrEP is invalid, saying, "Our well-supported view is that the U.S. government does not hold valid patents on the use of Truvada for pre-exposure prophylaxis, nor does it hold any patent for Truvada itself.” 

In the following weeks after the Post report, Gilead announced that the pharm giant would donate up to 2.4 million vials of PrEP each year for up to 11 years, in efforts to follow Trump’s plan of eradicating the virus by 90 percent by 2030. The medication will be distributed to approximately 200,000 individuals who are uninsured and at high-risk of transmission. 

Still, advocates say it’s  not enough given that there are nearly 1.1 million Americans at risk of contracting HIV who don’t have access to PrEP— including communities in the South, as well as trans and gay/bisexual men of color who can't afford it and are uninsured. 

The hearing consisted of Dr. Robert Grant, professor of medicine at the University of California, San Francisco; Dr. Rachelle Walensky, chief at the division of infectious diseases, Massachusetts General Hospital, and professor of medicine at Harvard; Tim Horn, director of medication access and pricing at the National Alliance of State and Territorial AIDS Directors (NASTAD); and Dr. Aaron Lord, PrEP patient and advocate who testified on behalf of PrEP4All. 

The three-hour long hearing was a direct result of the approach this year at #AIDSWatch2019, where advocates marched into the offices of Congress demanding for Gilead’s accountability. Representative Alexandria Ocasio-Cortez welcomed this meeting, along with other members of Congress, and was the leader in pushing this issue forward to a hearing. 

It was clear early on that certain representatives weren’t well-versed on PrEP, including Rep. James Jordan from Ohio, who asked: "What's the difference between PrEP and Truvada?" (PrEP is a term describing an HIV prevention strategy, whereas Truvada is the only drug FDA-approved the can be sold under this strategy). 

O’Day proclaimed that Gilead looks at many areas when pricing, including: "What’s the comparable treatment on the market today? What are the access limitations that might be created by setting that price? And what is our commitment to invest back into research?" 

Oversight Chairman Elijah Cummings, a Democrat from Maryland, pointed out that Gilead charged $800 a month for Truvada when it was introduced in 2004 and since then, has raised the price to $2,000 a month. He also spoke passionately about the folks who have died because they couldn’t afford their medication. 

“I applaud Gilead [for the work they do], but there’s nothing like holding the hand of someone who is dying of AIDS," Cummings spoke. "All we’re trying to do is represent our constituents and help them stay alive. When you’re dead, you’re dead. When I think about the fact that Truvada for prep is only getting to 10 percent of the people who need it, [I wonder] what about the other 90 percent?” 

Watch the full hearing below: