Brainstorm Health: Free HIV Medication, J&J Ketamine Drug Price, Physician Suicide

As we head into the weekend, a bit of intriguing news from the biotech world—drug giant Gilead will be donating hundreds of thousands of doses of HIV prevention drugs as part of a deal reached with the Trump administration.

“I’m pleased to announce that as a result of discussions between the Trump Administration and Gilead Sciences, Inc., Gilead has agreed to make a historic donation of HIV prevention medication for up to 200,000 individuals each year for up to 11 years,” wrote Health and Human Services Secretary Alex Azar in a tweet.

The treatment in question is a so-called PrEP drug called Truvada and, if actually enacted, could equate to several million bottles being given out to uninsured patients at high risk of contracting HIV. Truvada has shown to cut the risk of HIV transmission by well over 90% (if used regularly) among such patients.

Gilead’s deal with the administration is interesting for several reasons. For one, it’s part of President Donald Trump’s stated campaign to eliminate HIV in America. But it also hits on the reality that, despite Truvada’s existence, thousands upon thousands of patients who could benefit from it don’t have the financial resources to do so (it can cost close to $2,000 per month out of pocket).

It’s not a pure charity play by Gilead, though—the deal would only be in effect until the successor to Truvada hits the market. And that drug may eventually prove even more expensive than what’s already available.

Read on for the day’s news, and have a wonderful weekend.

DIGITAL HEALTH

DNA testing startups' bumpy road. Bloomberg has a fascinating report on the shifting strategies among DNA testing upstarts as they grapple with the complications of a highly personal, sensitive, and regulated industry. The a la carte DNA testing platform Helix serves as a prominent example: Once envisioned as a company that would conduct genetic testing and then allow users to access various other companies' services (whether for health or ancestry reasons), Helix is now looking to partner with health care providers who have more direct access to patients. (Bloomberg)

INDICATIONS

Johnson & Johnson criticized over ketamine depression drug price. Johnson & Johnson recently made history with an approved depression treatment derived from ketamine (commonly used as a party drug). But watchdogs are criticizing the company for what they say is unfair pricing. While the Institute for Clinical and Economic Review (ICER) considered the drug, Spravato, generally effective, cost-effectiveness was another question (the list price ranges from $4,720 to $6,785 for the first month of treatment and $2,360 to $3,540 in following months). “Esketamine shows some benefits for such patients and provides an FDA-approved treatment for treatment resistant depression [TRD] that may be covered by payers; however, it is concerning to have an overpriced therapy where there is such need for treatment. Additionally, the similarity of ketamine to esketamine raises issues for all stakeholders about how to consider off-label prescription and coverage of a treatment that has not been as well studied but is being increasingly used for TRD,” said ICER chief medical officer David Rind in a statement.

THE BIG PICTURE

Why are doctors dying by suicide? A pair of physicians (from Canada) have co-authored a paper exploring one of the most vexing questions in medicine: Why do physicians die by suicide at such high rates? One of the more interesting observations laid out by the study authors is that doctors may consider themselves physicians but not patients, potentially eschewing the very kind of help they'd prescribe to others. (Reuters)

REQUIRED READING

Commentary: Want to Lower Drug Costs for Patients? Start With Rebates, by Olivier Brandicourt & Steve Ubl

Uber's IPO Hits a Red Light as Stock Price Stays Below Opening, by Erik Sherman

Jeff Bezos Wants to Deliver You to the Moon, by Bloomberg