The price of Quad

[buginme2]

Gileads new Quad pill (expected to be approved soon ((tomorrow if I recall correctly)) may be priced at a rate that is unattainable for many. Insurance, ADAP, and other government programs may not be able to cover.  Media reports it may be priced at $34,000 USD per year.  Note:  Atripla costs about $20,000 (based on my insurance bills). 

Several members of congress wrote Gilead a letter requesting it be priced more affordably.  You can read the letter here

http://freepdfhosting.com/56e6356762.pdf

Something tells me Ill be sticking with Atripla.  Me wonders how this will play out.

[Common_ground]

Will Quad be a "hit"? What do you guys think?
If priced that high ( surely the letter indicates its going to be expensive) who will afford it/buy it?

[Miss Philicia]

Keep in mind it says "may be priced"... how can anyone speculate on anything until the actual price is reported?

[Common_ground]

Stock price? Analysts predict sales volume,market share,production costs and ROI for investors.
Will it be up for sales the same day as approved? Im guessing the price was already set months or even years ago...

Or to be more correct, the pricing strategy for the Quad has already been set a long time ago.

[Miss Philicia]

Media reports it may be priced at $34,000 USD per year. 

[surf18]

And is it really an upgrade? Like in a post i did a few weeks ago ,my doc says one of the meds in it might be more conducive to lipo. So who knows if its worth it?

[mecch]

Where is that The Rent is Too Damn High guy? We need him on our side.

[Miss Philicia]

poz.com

September 6, 2012

Gilead Sciences, Task Force Agree to ADAP Price Discount for Stribild

The AIDS Drug Assistance Program (ADAP) purchase price for the newly approved fixed-dose combination tablet Stribild will be substantially lower than the announced $28,500 wholesale acquisition cost (WAC), as a result of a new pricing agreement reached between Gilead Sciences and the ADAP Crisis Task Force (ACTF). According to a news announcement by the National Alliance of State & Territorial AIDS Directors (NASTAD), the national association that convened ACTF, the agreement also continues a price freeze on all Gilead’s antiretrovirals purchased by ADAPs through 2013. “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,” explained Dwayne Haught, manager of the Texas ADAP and a founding member of the ACTF.  “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.”

[Miss Philicia]

Following up on this initially hysteria laden thread, the end "retail" price of $28,500 is significantly lower than the first whisper campaign of $34,000 and according to the seemingly esteemed Nelson Vergel this compares with Complera at Atripla at $26,350 and $24,971/year (keeping in mind that the latter is based on medications well over a decade old, in fact sustiva is almost 15 years old)

That said, it's still less than an Isentress/Truvada regimen ($30,753), Reyataz/Truvada ($34,390) or Prezista/Truvada ($35,148) so I'm not sure why there was such a freak out even with the $34,000 price to begin with, though of course I am sympathetic to restraints with ADAP, I also figured the end result would be negotiated down for that program while private insurance would bill higher, as generally happens.

At the end of the day I don't personally find any of these new medications all that impressive, perhaps marginally, but not in the context of 2006/2007 when Prezista and Isentress came out.

[Buckmark]

Something tells me Ill be sticking with Atripla.  Me wonders how this will play out.

Why would you even want to switch, if Atripla is working for you?

[Buckmark]

At the end of the day I don't personally find any of these new medications all that impressive, perhaps marginally, but not in the context of 2006/2007 when Prezista and Isentress came out.

What is interesting to me is that two components of Stribild, cobicistat and elvitegravir, are new drugs, but are not being marketed individually, but only as part of the quad pill Stribild.  The suspicious part of me thinks Gilead is doing this to maximize their profits, though I can't see how.

I stand corrected, it looks like elvitegravir has been submitted to the FDA for approval:  http://www.hivandhepatitis.com/hiv-treatment/experimental-hiv-drugs/3648-gilead-submits-application-for-fda-approval-of-hiv-integrase-inhibitor-elvitegravir

The same goes for cobicistat, which is a booster intended to compete with Norvir.  I'll bet Abbott Labs isn't happy about that, since they've been price-gouging on Norvir for years.

[Miss Philicia]

The all-in-one formulation was approved first simply because that's the first thing that was done in clinical testing, from what I recall.

[MitchMiller]

As I understand it, the strategy is to grow market share by making it a first line treatment.  Their sales force will push study results that showed lower CNS symptoms.  By the time patents expire on Atripla, they hope to have a large enough market share so existing profits won't be so much affected.

However, I can't believe private insurance will simply cave and not insist that stribild be by special approval only (which means no unless there's no other choice).   But then again, as long as they can just keep raising premiums, why argue.

[mikeyb39]

i think that if your current medications are working id stick to what you have, at least for now.  all new medications are gonna be expensive.  Frankly i don't see much 'new' medicatiions in this formulation.  the new medications in this pill are almost exactly similar to what we already have except that they just combined it in one pill.

I'd like to see something new that had less effects on kidneys, nerves, CNS issues.

[scottieman]

I've been on Complera since November, and the last two months I've had a blip in my VL first in the 50's and next in the 90's my Dr has told me that he has seen a number of his patients on Complera having these blips.  He wants to switch me to the Stribild because it's a one a day pill, you don't have a calorie requirement and it has a booster built in.  The caveat is my insurance has it listed as a non-preferred so my out of pocket is $950.00 a month which I can't afford.  I have to order my meds thru Medco, which won't allow the use of the co-pay card so I have to pay all and then get a check back from Gilead for the co-pay card.  Still not affordable for me.  My insurance had Complera on the preferred list in about a month after it was released.  Thoughts?

[buginme2]

Why no Atripla? 

Is the "one pill per day" a deal breaker?   Otherwise I would go Isentress/truvada or Prezista/Norvir/Truvada.

My doc and I had a discussion about Stibild last week.  Hes not recommending it to his patients yet.  There are some unanswered questions regarding the kidney issue.

[scottieman]

He doesn't want me to Atripla because of Cholesterol issues.

[buginme2]

US treatment guidelines just listed Stribild (Quad) as an "alternative" first line treatment option instead of a preferred option.


The decision to initially list Stribild as an alternative medication is mostly based on our relative lack of information about the drug's long-term effects. The panel cited study data that only extend 48 weeks from the time people began taking Stribild, potential concerns regarding creatinine clearance and kidney damage, and a lack of data on women and on people with advanced HIV disease. The panel also noted that the drug carries a large number of drug-to-drug interaction risks and must be taken with food, which can make adherence more difficult.


http://www.thebody.com/content/69126/stribild-quad-recommended-as-alternative-first-lin.html

[Miss Philicia]

This is not unusual. Same thing happened with Prezista and Isentress.