Philadelphia is the leading municipality tackling price-gouging by drug giant Gilead over its hepatitis C drug Sovaldi.
The City of Brotherly Love's transit agency SEPTA last week filed a federallawsuit, which according to a release from the law firm handling the case, explains the pricing problem:
"Gilead's exorbitant pricing scheme has the potential to bankrupt segments of the U.S. health care system ... [which has] also had the effect of pricing certain consumers and government programs out of the Sovaldi market, thus preventing sick patients from obtaining this critical drug. ... Meanwhile, Gilead has recorded an astounding $8.5 billion in Sovaldi sales through the first three quarters of 2014 alone."
Many HIV-positive San Franciscans are co-infected with hepatitis and the cost of their AIDS cocktails is exorbitant enough, so for them adding Sovaldi to the mix is a heavy fiscal burden.
The City That Knows How needs to catch up with Philadelphia's leadership holding Gilead to account for outrageous pricing, to protect the wellness of patients and the public health budget.
The company reaped millions of dollars of favorable publicity, when the two gay members of the Board of Supervisors, David Campos and Scott Wiener, recently spoke at City Hall rallies and held hearings about getting more at-risk individuals on Truvada as part of an HIV pre-exposure prophylaxis effort. Little was said regarding Truvada's price tag.
Proposition D, a 2013 advisory statement on the city ballot, asked, "Shall it be city policy to use all available opportunities to reduce the cost of prescription drugs?" and 80 percent of voters said yes.
The Board of Supervisors earmarked funds for the Department of Public Health to hire navigators to process the paperwork of getting insurance to cover the cost of a person's Truvada or receive it through Gilead's patient assistance program. All well and good, in my opinion.
But secondly, Prop D wasn't used by the supervisors as a foundation to invite Gilead representatives to testify about pricing, which is the key reason why DPH needs additional navigators.
There's no reason why the supervisors can't schedule several hearings in 2015 about all of Gilead's pharmaceuticals.
Since Sovaldi, at $84,000 for 12 weeks of treatment, is so expensive and providing it to one inmate of San Francisco's jail system, where hepatitis is rampant, would eat up one-tenth of the jail's entire annual health budget, the price keeps Sovaldi from the inmate population.
All city residents in need of this hepatitis drug must have access to it without worrying about going bankrupt to afford it.
Who's been a hero in terms of attacking Gilead from several angles over pricing?
None other than Michael Weinstein, the president of the AIDS Healthcare Foundation and devil to all PrEP advocates because of his irrational opposition to using Truvada to stop new HIV infections.
As a longtime AIDS accountability advocate and after years of loud criticism against Weinstein for failing to post AHF's IRS 990s on his group's site, and deploring his attacks on the sexual health choices of erotic performers, not to mention his war on Truvada, which led me to organize a picket at its Castro pharmacy, it pains me to say this.
Weinstein is an HIV hero for biting the Gilead hand that used to feed him. I broke the news in April that from 2005 through 2011, AHF accepted more than $10 million from the company, so I'm very aware of how much money he took from the company before attacking it.
It's a great benefit that AHF owns enough shares in Gilead so that it could submit a corporate resolution at this year's annual shareholders meeting tying the CEO's hefty bonus to greater patient access to their popular AIDS and hepatitis drugs. The resolution failed, but the black eye of bad publicity sent Gilead a message about its greed.
Weinstein was also behind Prop D and has run attack ads over Gilead's pricing. Labeling him a hero over affordability doesn't negate his un-scientific advocacy against PrEP.
Other AIDS nonprofits, including the San Francisco AIDS Foundation and the Gay Men's Health Crisis in New York, receive enormous grants from Gilead for general operating expenses and just happen to also engage in community education about Truvada as PrEP.
Gilead money is going into the coffers of AIDS charities, which is a fact of life, but there needs to be full and easy-to-locate transparency from the charities about the pharma grants on their sites.
Equally important is to have the nonprofits receiving Gilead grants deplore Gilead's sky-high pricing and demand serious and immediate reduction of what patients pay for their products.
Silence from SFAF, GMHC, and other Gilead grant recipients about pricing is potentially deadly for thousands of us living with either HIV or hepatitis, or both. James Loduca, the foundation's current vice president for philanthropy and public affairs, was Gilead's spokesman before joining the nonprofit, an example of the incestuous relationship between Big Pharma and AIDS Inc.
The coalition of AIDS nonprofits, supervisors, and gays on Truvada behind the City Hall rallies need to reactivate their network for hearings on Prop D and using all levers of city government to curb Gilead's price-gouging on their lines of HIV and hepatitis medicines.
San Francisco nonprofits, public health and elected officials must also consider emulating Philadelphia's legal battle to force Gilead to put people before profits. The wellness of many LGBT people depends on it.
[This essay originally appeared in the Dec. 18 edition of the Bay Area Reporter and I say thanks to the editor Cynthia Laird for giving my views a platform in San Francisco's weekly LGBT paper.]
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