The PrEP Farce and the $3 BILLION the White House Refuses to Collect

WASHINGTON, DC—Gilead Sciences, Inc., the manufacturer of the HIV medication Truvada, has agreed to begin supplying the drug for free to 200,000 uninsured individuals who would benefit from pre-exposure prophylaxis (PrEP.) The Trump Administration is congratulating itself for negotiating the donation. The move is a “major step” in ending the AIDS epidemic, according to HHS Secretary Alex M. Azar II.

“Securing this commitment is a major step in the Trump Administration’s efforts to use the prevention and treatment tools we have to end the HIV epidemic in America by 2030,” Azar said. 

“Under President Trump’s leadership, HHS worked with Gilead to secure preventative medication for individuals who might otherwise not be able to access or afford this important treatment. The majority of Americans who are at risk and who could protect themselves with PrEP are still not receiving the medication.

“This agreement will help close that gap substantially and deliver on President Trump’s promise to end the HIV epidemic in America.” Blah, blah, blah.

What the government is not saying, however, is that after Gilead developed the drug, the Centers for Disease Control and Prevention (CDC), a Federal Agency, spent several years researching the drug’s effectiveness as PrEP.  The FDA approved the drug’s use as PrEP in 2012. While Gilead holds the patent on Truvada as an HIV treatment, the U.S. government holds the license on its use as a pre-exposure prophylaxis.

The White House seems blissfully unaware that it has just negotiated a gift from Gilead that doesn’t belong to Gilead to give. Rather it belongs to the U.S. Government, or rather the U.S. taxpayers who paid to research its use and own the patent until the year 2035.

Making matters worse, Gilead is charging $20,000 a year to PrEP users covered by insurance for the drug. There are currently estimated to be 170,000 U.S. citizens taking (and paying for) Truvada as PrEP. Gilead is making over $3 billion a year on the drug. $3 billion! And out of that $3 billion, the U.S. Government has received zero—nothing—as the patent-holder.

While President Trump is bragging with arms akimbo about the budget he has allotted—all $291 million—to “End the Epidemic” by the year 2030, he has said nothing of the $3 billion he has left lying on the table for Gilead to add to its corporate profits. Imagine what type of HIV/AIDS healthcare initiative the remaining $2.7 billion could finance.

Instead, the CDC is refusing to discuss the unclaimed patent dollars, money which has been confirmed by no less an authority than Dr. Anthony Fauci, Director of NIAID, and the doctor credited with discovering how the HIV virus infects T4 cells and allows the human body to be susceptible to disease.

Also, amid all the hoopla, Gilead Sciences has neglected to mention that in the private sector, Truvada is now outdated, replaced by a newer, less kidney-damaging drug called Descovy, that it also manufactures. While Descovy is being prescribed by doctors across the country to HIV patients, Truvada is being pushed on to the public as the PrEP drug of choice until Descovy is approved by the Food and Drug Administration for PrEP.

With a new patent on Descovy just beginning to tick, Gilead has announced that it is surrendering its patent on Truvada a year early so that a generic form of the drug can be manufactured. Of course, once Descovy is approved for PrEP (presumably sometime next year as well), Truvada will no longer be the drug of choice, and Descovy will be pushed at full retail price which is slightly higher than Truvada, thereby making even more money for Gilead Sciences.

Additionally, while the Trump administration hails the Gilead move as a victory in the fight against HIV, it does nothing to lower the price of the drug—either for those who are still covered by insurance and need PrEP, or for those with HIV or full-blown AIDS, who need the drug to combat the actual disease.  Those with HIV and AIDS need a combination of drugs, typically labeled “the cocktail” to keep the virus at bay, although it does not cure it. Meanwhile, the costs of the medicines keep rising, right along with the bottom line at Gilead Sciences Inc.

Richard Hack is an award-winning author and journalist. He Is LGBTQ Loyalty Holdings' Vice President of Content and Executive Editor of

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