At first blush, the news that Gilead — the company that makes Truvada, the medication that prevents H.I.V. infection — will donate enough of the drug to treat 200,000 patients a year through 2030 seems like unequivocally good news. Some 40,000 Americans are newly infected with H.I.V. every year. Reducing that transmission rate is the key to eradicating the virus in the United States, as President Trump has vowed to do by 2030. And increasing access to Truvada is widely seen as the best way to do that.
But, as drug policy experts regularly note, such donations have a long history of doing more for drug makers than for patients.
A month’s supply of Truvada costs roughly to make and sells for more than ,600 in the United States, according to the PrEP4All Collaboration, an advocacy group. (PrEP stands for pre-exposure prophylaxis, a strategy to prevent H.I.V. infection.) Owing partly to those prices, only about 18 percent of the million or so at-risk Americans who need the drug have access to it, according to the Kaiser Family Foundation. Gilead’s donation could double that percentage, but only if it’s reserved for patients who aren’t already receiving Truvada through the company’s existing financial aid programs. The deal, which Mr. Trump is said to have negotiated himself, contains no such guarantee.
That’s a missed opportunity. As The Washington Post has reported, Truvada was developed largely with taxpayer dollars. The Centers for Disease Control and Prevention holds a patent on the medication, and the Justice Department is investigating whether the company owes the federal government back royalties on that patent, which experts say could amount to as much as billion. (Gilead has roughly billion in annual global sales of Truvada.)
Officials at the Department of Health and Human Services have resisted calls to sue the company for those royalties, saying that such a lawsuit would be expensive and time-consuming and would ultimately not make much of a dent in the drug’s price. They’re probably right. But the prospect of such a lawsuit should have given the government considerable leverage in its negotiations with Gilead.
Mr. Trump appears to have used that leverage poorly. Regardless of how much access to Truvada is increased by the new donation, most Americans who need Truvada will still be charged thousands of dollars a year for the drug, which citizens of most other countries get for a small fraction of that price. Those other countries made no investment in the development of Truvada, but most have access to generic versions of it. Gilead has managed to keep its rivals from introducing generics to the American market through a combination of lawsuits and private deals with would-be competitors.
The company is likely to receive a generous tax break for its latest donation. Drug policy researchers have speculated that if the value of that donation is set by Truvada’s list price, rather than its manufacturing cost, Gilead could reduce its tax liability by about billion. The donated drugs will cost the company less than million to produce.
And then there’s the much bigger tragedy lurking in this news: No matter how Gilead’s donation turns out, a majority of patients who would benefit from Truvada — and whose tax dollars helped pay for its development — still won’t be able to get the drug. Gilead notes, rightly, that its donation is one of the largest ever of medication in the United States. But much more is needed, from the nation’s drug companies and its government, to get Americans the lifesaving medications they need.
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【离】【陌】【回】【家】【的】【时】【候】，【已】【经】【很】【晚】【了】，【客】【厅】【的】【灯】【是】【关】【了】【的】。 【这】【个】【时】【候】，【软】【软】【应】【该】【睡】【了】。 【离】【陌】【开】【灯】，【扭】【过】【头】，【沙】【发】【上】【坐】【着】【一】【个】【人】。 【景】【黎】【渊】【就】【在】【沙】【发】【上】【直】【挺】【挺】【的】【坐】【着】。 “【这】【么】【晚】【了】【怎】【么】【还】【不】【睡】【觉】？”【离】【陌】【走】【过】【去】，【她】【走】【到】【景】【黎】【渊】【面】【前】【的】【时】【候】，【突】【然】，【景】【黎】【渊】【伸】【手】，【将】【她】【一】【搂】。 【离】【陌】【整】【个】【人】【就】【扑】【在】【了】【景】【黎】【渊】【身】【上】
【如】【果】【人】【生】【是】【一】【场】【游】【戏】，【桐】【人】【的】【人】【生】【就】【算】【不】【是】《【黑】【暗】【之】【魂】》，【也】【不】【会】【差】【太】【多】。 【别】【看】【他】【现】【在】【风】【风】【光】【光】，【妥】【妥】【人】【生】【赢】【家】【的】【样】【子】，【其】【实】【这】【全】【是】【他】【拿】【命】【换】【来】【的】——【没】【有】【开】【玩】【笑】，【真】【是】【拿】【命】【去】【换】，【开】【挂】【玩】【家】？NONONO——【真】【要】【说】【是】【氪】【命】【玩】【家】【才】【对】。 【从】14【岁】【进】【入】SAO【开】【始】，【他】【在】【生】【死】【边】【缘】【反】【复】【横】【跳】【的】【次】【数】【绝】【对】【超】【过】【两】
【小】【章】【鱼】【吃】【得】【津】【津】【有】【味】，【伸】【出】【触】【手】【挖】【出】【一】【块】【骨】【髓】【分】【给】【杰】【克】【一】【点】，【杰】【克】【盯】【着】【那】【块】【骨】【髓】，【黑】【透】【晶】【莹】【的】，【看】【上】【去】【就】【仿】【佛】【黑】【色】【水】【晶】，【透】【着】【一】【种】【低】【调】【的】【奢】【华】。【就】【是】【再】【怎】【么】【好】【看】【想】【到】【这】【东】【西】【的】【来】【处】，【杰】【克】【也】【不】【敢】【吃】【啊】。【他】【面】【无】【表】【情】【拒】【绝】，【转】【身】【面】【对】【缝】【隙】，【看】【见】【那】【因】【为】【毁】【了】【一】【点】【船】【而】【表】【现】【萎】【靡】【的】【暗】【影】【怪】【物】。 【此】【时】【杰】【克】【已】【经】【没】【有】【剩】【余】【的】【精】2016年救世通天彩图第六期【我】【认】【真】【研】【究】【了】【一】【下】【本】【书】，【发】【现】【前】【期】【写】【的】【并】【不】【好】，【或】【许】【这】【是】【硬】【伤】【吧】，【目】【前】【就】【两】【个】【想】【法】，【一】【个】【开】【本】【新】【书】，【一】【个】【以】【本】【书】【剧】【情】【为】【蓝】【本】，【推】【倒】【重】【写】。 【有】【兴】【趣】【的】【朋】【友】【可】【关】【注】【本】【书】【消】【息】，【或】【者】【加】【企】【鹅】【群】:832719791
【章】【杨】【回】【到】【国】【内】【休】【息】【了】【几】【天】，【又】【一】【次】【飞】【向】【了】【迈】【阿】【密】。【这】【次】【的】【年】【可】【能】【要】【在】【美】【利】【坚】【过】【了】，【明】【年】【说】【什】【么】【也】【要】【调】【整】【一】【下】【比】【赛】【时】【间】。 【所】【有】【比】【赛】【的】【第】【一】【轮】【都】【已】【经】【结】【束】，【队】【伍】【和】【参】【赛】【选】【手】【都】【淘】【汰】【了】【接】【近】【一】【半】，【还】【有】【许】【多】【国】【家】【的】【代】【表】【队】【全】【军】【覆】【没】。 【其】【中】【华】【夏】、【美】【利】【坚】、【岛】【国】、【南】【韩】【和】【不】【列】【颠】【五】【个】【国】【家】【剩】【余】【的】【队】【伍】【与】【参】【赛】【选】【手】【最】【多】。
“【若】【道】【友】【将】【鄙】【人】【受】【困】【在】【此】【的】【消】【息】，【传】【达】【给】【灵】【族】，【定】【会】【得】【到】【丰】【厚】【的】【报】【偿】……” 【先】【敲】【打】【真】【小】【小】，【不】【能】【像】【杀】【死】【龙】【血】【藤】【那】【样】，【毫】【不】【客】【气】【地】【杀】【死】【自】【己】，【再】【许】【以】【重】【金】，【云】【中】【楼】【的】【表】【情】，【勉】【强】【恢】【复】【从】【容】，【感】【觉】【自】【己】【与】【小】【白】【马】【之】【前】，【还】【能】【再】【进】【行】【一】【场】【交】【易】。 “【做】【人】【怎】【么】【能】【这】【样】【无】【耻】【呢】？【之】【前】【还】【想】【杀】【了】【我】【们】【来】【着】。” 【真】【小】【小】【嘴】【角】
【灵】【石】【数】【目】【在】【不】【断】【增】【长】，【毕】【竟】，【血】【莲】【这】【种】【东】【西】【可】【遇】【不】【可】【求】。 【用】【的】【好】【的】【话】，【还】【能】【让】【自】【己】【家】【族】【的】【势】【力】【更】【上】【一】【层】【楼】。 “【三】【十】【万】【上】【品】【灵】【石】【一】【次】，【三】【十】【万】【上】【品】【灵】【石】【二】【次】，【三】【十】【万】【上】【品】【灵】【石】【三】【次】，【恭】【喜】【四】【楼】【三】【号】【包】【厢】，【获】【得】【本】【次】【拍】【卖】【的】【血】【莲】！”【拍】【卖】【师】【一】【敲】【定】 【底】【下】【众】【人】【的】【神】【色】【各】【异】 【拍】【卖】【师】【笑】【了】【笑】：“【下】【面】【是】【本】【次】【拍】【卖】【倒】