AHF: Gilead’s Stribild Not Covered by NY Medicaid; State Also Explores ‘Prior Auth’ Status for AIDS Drug

<0> AHF: Gilead’s Stribild Not Covered by NY Medicaid; State Also Explores ‘Prior Auth’ Status for AIDS Drug </0>

<0> AIDS Healthcare FoundationCommunications DirectorLos Angeles, CA, USA+1.323.791.5526 [mobile]+1.323.308.1833 [work]orPublic Affairs ManagerWashington, DC, USA+1.213.590.7375 [mobile] </0>

(AHF) today reported that the New York State Department of Health’s Medicaid program does cover expensive new AIDS drug , its new four-in-one treatment combination, which was approved by the Food and Drug Administration (FDA) in early September and then immediately priced by Gilead at $28,500 per patient, per year, Wholesale Acquisition Cost (WAC). That price was over 35% more than Atripla, the company’s best selling combination HIV/AIDS treatment, and made Stribild the highest priced first line combination AIDS therapy.

As a result and on the heels of a recent pricing agreement on Gilead’s new four-in-one AIDS tablet that was reached with the ADAP Crisis Task Force (ACTF) of the on behalf of the nation’s hard-hit network of AIDS Drug Assistance Programs (ADAPs), officials from AHF pressed Gilead to similarly lower the price for Medicaid, Medicare, private insurers and other payors that otherwise face Gilead’s steep price tag for the new medication. AHF officials also sent letters to private insurers and state health department directors nationwide urging that those programs exclude Stribild from their drug formularies if the drug was not priced price-neutral to Atripla. On September 14, 2012, , Deputy Director, Division of Program Development & Management for the New York State Department of Health responded via noting that, and that the state is also,

“We asked the state arms of programs like Medicaid to exclude Stribild from their drug formularies or place the medication on ‘prior authorization’ status if Gilead does not make it price-neutral to that of their price for Atripla,” said , President of AIDS Healthcare Foundation. “The price of this drug was simply too high to start with and the price cut offered ADAP was not shared widely enough with other struggling insurance and assistance programs. As tax dollars pay for most of these drugs, we continue our call on Gilead to expand price concessions on Stribild to other programs including Medicaid, Medicare, private insurers and other payors.”

In its August 21 letter to the NY State Department of Health, AHF’s Weinstein wrote:

“While we expect this drug [Stribild] to be significantly more expensive than existing HIV medications, there is no justification for this; it does not provide a significant clinical benefit over these medications, and is less safe. Therefore, to safeguard the public health, we request that your state place the Quad on Prior Authorization in your ADAP and Medicaid programs. This will ensure the Quad [now called Stribild] is only prescribed to patients when there is a documented need for it, and also will help ensure access for people with HIV/AIDS to these safety net programs.”

(AHF), the largest global AIDS organization, currently provides medical care and/or 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: .