Trump's HIV pledge comes as Gilead pumps cash into Truvada for PrEP

Gilead is looking to eventually sub out Truvada for its newer HIV drug Descovy when it comes to pre-exposure prophylaxis. But in the meantime, it’s socking cash into promoting the older brand for PrEP.

The company has "actually put a significant amount of additional funding" behind Truvada for PrEP this year, commercial chief Laura Hamill said on Monday’s fourth-quarter earnings call, adding, "we believe that’s a very important thing to do."

It's a move that could get a boost from President Donald Trump's new promise to stamp out HIV, made during Tuesday's State of the Union address. PrEP will play a role in that new effort meant to wipe out transmission of the virus in the U.S., and HHS will be seeking funding to back that effort, Secretary Alex Azar told The New York Times.

While preventative use of Truvada continues to grow in the U.S.—sales swelled to $784 million in the fourth quarter, up from $631 million in the same period of 2017—"we really believe there’s a lot more to do. There’s a lot of populations that are affected that just don’t have the awareness that they really need to protect themselves," Hamill said.

How many, exactly? The Big Biotech estimates that about 202,000 people were taking Truvada for PrEP at the end of last year. But that number pales in comparison to the 1.1 million people in the U.S. the CDC estimates could benefit from PrEP, Hamill noted: "There is still so much more we can do."

In 2018, the company took to the airwaves with two DTC campaigns to build awareness, and it fields a team of therapeutic specialists focused on Truvada for PrEP, Hamill said. Gilead also has "a number of commercial programs aimed at helping populations, disproportionately impacted by HIV, where utilization of Truvada for PrEP is low."

And the company isn’t promoting the drug alone, either. "We have a lot of community individuals that have come from nonprofits that are very much committed to helping these communities, and we are leading into these communities to try to raise awareness," Hamill said.

The Trump administration will also be looking to increase the use of PrEP drugs as part of its new initiative, according to Anthony Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases. The plan is to reduce the number of new infections by 75% over five years—and to end the spread of the disease in the U.S. by 2030—by targeting the 48 counties where about half of new infections crop up.

If Gilead gets its way, it’ll soon be switching gears to back Descovy as PrEP instead of Truvada. The California drugmaker is currently awaiting results from a phase 3 study pitting Descovy against the older drug to see whether Descovy proves as safe and effective at cutting the risk of HIV infection.

Gilead has already steered patients who are being treated for HIV toward that drug, which is now the backbone of treatment in a majority of its prescriptions. "And we believe that the benefits that accrue to a patient for HIV are the same benefits that we need to have for a patient at risk that is being treated for PrEP," Hamill said.

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