September 10, 2012
The ADAP Crisis Task Force (ACTF) has reached a new pricing agreement with Gilead Sciences, Inc. for AIDS Drug Assistance Programs (ADAPs) for Stribild, the newly approved four-drug combination pill for the treatment of HIV-1 in treatment-naïve individuals. The ADAP direct purchase price for Stribild negotiated between the ACTF and Gilead is substantially lower than the wholesale acquisition cost (WAC), reflecting voluntary discounts that are also significantly below the mandated 340B pricing of the medication. The Public Health Service's 340B drug discount program provides qualifying entities, including ADAPs, with an estimated 20% to 50% savings on the cost of pharmaceuticals.
The ACTF has a long history of working collaboratively with Gilead Sciences to provide ADAPs access to discounted pricing on Gilead's HIV drugs. The special pricing of Stribild is in addition to that mandated by current law and the Affordable Care Act, and adds another treatment option to other products included in previous agreements between the ACTF and Gilead. This agreement also continues a price freeze on all Gilead's HIV medications purchased by ADAPs, including Stribild, through 2013. In addition to this agreement, the ACTF has worked collaboratively with the Fair Pricing Coalition (FPC) and Gilead to expand access to medications outside of ADAP through the company's Patient Assistance Program and Co-Pay Assistance Program.
"The fiscal crises many ADAPs continue to experience require ongoing and new commitments on the part of pharmaceutical companies, as well as federal and state governments," stated Dwayne Haught, manager of the Texas ADAP and a founding member of the ACTF, in a press release. "We thank Gilead for agreeing to price this new medication for ADAPs at a point that will allow access to it for clients without adversely impacting ADAP budgets. Our long working relationship with Gilead and the considerable savings generated by previous pricing agreements made this new agreement possible," added Haught.
The ACTF, convened by the National Alliance of State and Territorial AIDS Directors (NASTAD), has secured significant multi-year, voluntary discounts and rebates from all eight manufacturers of HIV antiretroviral (ARV) medications, with many of them also providing price freezes for ADAPs through 2013. However, ongoing state and federal budget challenges coupled with the increasing numbers of clients seeking ADAP services have created a situation requiring an ever-increasing investment of state and federal funds in addition to these cost savings.
While pleased with the ADAP price of Stribild, the ACTF acknowledges the disappointment and controversy within the larger HIV community about the $28,500 annual WAC price. According to the press release, setting the price of Stribild above Atripla and the previously approved Isentress regimen, despite being less than several protease inhibitor-based regimens, may affect costs outside of ADAP, including:
The ACTF urges Gilead and other HIV manufacturers to consider the implications of cost to the ability of patients to access these medications when setting prices and developing patient assistance programs.