Prices for both of the one-pill, once-a-day medications for HIV had already been increased by 7% and 5%, respectively, in January. Their Wholesale Acquisition Cost is now $2,508 a month for emtricitabine-rilpivirine-TDF and $3,469 per month for elvitegravir-cobicistat-emtricitabine-TDF.
With the combined price hikes, the two older drugs now cost more than the company’s new HIV drugs: $2,346 for the emtricitabine-rilpivirine-TDF follow-up Odefsey, approved by the FDA in March 2016, and $2,578 per month for the elvitegravir-cobicistat-emtricitabine-TDF successor Genvoya, approved in November 2015. In both of these regimens, TDF is replaced with tenofovir alafenamide, which enters cells more efficiently, requiring a lower dose of the drug and inducing less toxicity in bones and kidneys.
“Since Complera and Stribild are the only two HIV regimens that Gilead has targeted for price hikes, it seems that they are potentially trying to influence people to switch to these new and safer formulations,” said Melissa Badowski, PharmD, BCPS, AAHIVP, a clinical assistant professor in the Section of Infectious Diseases Pharmacotherapy at the University of Illinois at Chicago College of Pharmacy and the founding chair of the American College of Clinical Pharmacy’s HIV Practice.
“I know the newer agents aren’t on all of the formularies yet, especially with managed Medicaid organizations. At least in Illinois, you can only review the formulary a couple of times a year, and it usually takes awhile for new drugs like these to be put on formulary. It may be an incentive to add these newer, safer drugs to the formularies now that their price is lower,” she added.