AHF Asks State Health Departments & AIDS Directors, Private Insurers to Place Gilead’s New ‘Quad’ Pill on ‘Prior Authorization’ Status

<0> AHF Asks State Health Departments & AIDS Directors, Private Insurers to Place Gilead’s New ‘Quad’ Pill on ‘Prior Authorization’ Status </0>

<0> AIDS Healthcare Foundation, Communications DirectorOffice: 323-308-1833Cell: 323-791-5526 </0>

In what may be an unprecedented move on drug pricing and access, advocates from are calling on state AIDS and Medicaid directors as well as a number of private medical insurers nationwide asking them to place new pill — a four-in-one, once-daily HIV/AIDS combination tablet — on ‘Prior Authorization’ status on their respective drug formularies. In general, ‘Prior Authorization’ requires that a particular prescription must be reviewed by a second medical provider for assessment of medical necessity before being filled for a particular drug, and the process may add a day to the timeline of a filling a prescription.

It is widely expected that Gilead will get FDA approval for the ‘Quad’ sometime within the next two weeks — and also expected that it will likely then price the combination therapy at thousands of dollars more than drugs that state AIDS Drug Assistance Programs (ADAP) currently purchase.

In response, AHF this week began sending asking leaders of state government programs and private insurers to place the potentially cost-prohibitive AIDS drug on prior authorization status once it has been FDA-approved and comes to market in order,

Later in the letter, AHF wrote:


The letter adds:

Over the past months, AIDS advocates from AHF and other groups have spearheaded a campaign urging , CEO of Gilead,not to decimate ADAP and other drug programs by pricing its latest HIV/AIDS drug combination, the ‘Quad,’ higher than Gilead’s Atripla, currently the most prescribed HIV/AIDS medication. Earlier this week, a group of U.S. Congress members wrote to Mr. Martin telling him that they are by media reports indicating Gilead may charge may charge thousands more than existing AIDS drugs for the ‘Quad.’ In the , the Congress members also urged Gilead

“Gilead’s excessive pricing of it AIDS drugs has generated record profits for it, and $53 million in annual pay for its CEO, John Martin (making him the 10 highest paid executive in the nation),” However, this has come at the expense of state ADAP and Medicaid programs, the largest purchasers of Gilead’s products, and the people living with HIV/AIDS that rely on these programs but cannot access them due to funding constraints. To save lives, curb the spread of HIV, and lower long-term care expenses, it is imperative to get more patients tested and into antiretroviral treatment. This will be impossible if we continue to introduce new HIV drugs, like the Quad, at prices higher than the drugs they replace.”

In California, advocates from AHF previously — and successfully — asked for ‘Prior Authorization’ status for Serono’s drug, (somatropin), a drug used to combat AIDS wasting and weight loss in HIV/AIDS patients. AHF sought ‘Prior Authorization’ status for Serostim because many doctors and providers believed it was medically unnecessary if patients faithfully followed their antiretroviral (ARV) drug regimens — and because the drug has a price tag of over $7,000 . It is widely believed that AHF’s request to have Gilead’s ‘Quad’ placed on ‘Prior Authorization’ status is the first such request for any antiretroviral therapy used to treat HIV/AIDS.

(AHF), the largest global AIDS organization, currently provides medical care and services to more than 176,000 individuals in 27 countries worldwide in the US, Africa, Latin America/Caribbean the Asia/Pacific region and Eastern Europe. To learn more about AHF, please visit our website: , find us on Facebook: and follow us on Twitter: @aidshealthcare.