Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.
San Francisco Chronicle - Wednesday, December 18, 2002
Tom Abate, Chronicle Staff Writer
The pledge by the Foster City biotech firm left unanswered a key detail -- how steeply the company will discount its one-a-day AIDS drug called Viread that wholesales for about $10 a day in the United States.
Gilead chief executive John Martin said he thought manufacturing and distribution costs would dictate a rock-bottom price at or under $3 a day when the program begins in the spring.
Even as activists agitated for even steeper discounts, prominent AIDS fighters gave Gilead an "A" for effort.
"This is a pretty bold step for a company this young," said Rene Durazzo, with the Pangea Global AIDS Foundation, the world health spin-off of the San Francisco AIDS Foundation.
Chris Collins, director of the AIDS Vaccine Advocacy Coalition and a former aide to House Minority Leader Nancy Pelosi, D-San Francisco, said Gilead had set an example for the rest of the industry.
"This is where the pharmaceutical industry should have been long ago," Collins said, "planning to make a reasonable profit in the richer countries, while offering steeply tiered (discounted) prices in poorer countries."
Viread has been on the market a little over a year in the United States. It has excited AIDS doctors and patients because it can be taken once a day and has been shown effective against strains of HIV that have become resistant to previous drugs.
Sales of Viread, which has about 75,000 regular users in the United States, have made Gilead profitable -- a rarity among biotech firms.
Martin said Tuesday that the company's officers and board had always planned to make a low-cost version of the pill available in poor nations once the firm had put the company on a sound financial footing.
Martin said Gilead also wanted to wait a year to announce the no-profit pledge for the developing world in order to make sure no safety problems cropped up when thousands of patients began taking the pill daily.
"We're talking about using these drugs in parts of the world where the medical oversight isn't there," he said.
Excited though they are about the program, Gilead officials downplayed expectations. Right now, for instance, upwards of 30 million Africans are infected with HIV, yet only 30,000 are getting antiretrovirals because there isn't money -- even at the reduced rates that are becoming available for others AIDS drugs -- to treat more patients.
Economist Hannah Kettler, director of the Institute for Global Health in San Francisco, said programs such as Gilead's would still require someone to buy the drug, since the company can't afford to simply give away millions of pills a day.
"International agencies, foundations and governments have to step up and create buying funds," Kettler said.
Carl Feldbaum, president of the Biotechnology Industry Organization, which recently held a world health forum in Washington, D.C., said Gilead's pledge demonstrated that the biotech industry understood that world opinion was demanding action to confront the AIDS crisis.
"John Martin and Gilead just get it," Feldbaum said.
Email Tom Abate at tabate@sfchronicle.com.
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