| NEW YORK
NEW YORK Nov 30 Gilead Sciences Inc
has begun marketing its HIV treatment Truvada in a way thousands
of consumers already use it - to prevent infection with the
virus that causes AIDS.
The company introduced Truvada to the U.S. market in 2004
for HIV treatment. In 2012, Gilead won approval to market it for
prevention after two large, peer-reviewed studies showed it also
was effective at preventing infections in healthy people.
But the company decided against promoting the drug as a
preventative treatment, deferring to patient advocates who
feared it could encourage promiscuity and unsafe practices, such
as having sex without condoms.
Even without Gilead's help, many consumers learned Truvada
was more than 90 percent effective in tests at preventing HIV
infection. In 2014, the U.S. Centers for Disease Control and
Prevention recommended it as an option for people at high risk
for HIV infection.
As many as 90,000 people in the United States used the drug
for prevention, or pre-exposure prophylaxis (PrEP), last
quarter. That's up from 60,000 to 70,000 earlier this year, the
company said. Usage also is growing in France, where about 2,000
people have been prescribed Truvada for prevention since
In July, the drugmaker began marketing Truvada for PrEP to
doctors through professional publications, digital advertising
and other channels, including the website PreventHIV.com.
And this fall, the drugmaker began marketing directly to
consumers with print advertisements in publications geared
toward the lesbian, gay, bisexual and transgender community,
including OUT, Advocate and SWERV. It plans soon to expand to
social media and digital.
Gilead said it wants to reach people whose doctors are
either unaware or reluctant to prescribe Truvada for prevention.
The marketing "is primarily driven by demand by patients,"
said David Piontkowsky, Gilead's vice president of HIV Medical
Affairs, in an interview.
Attitudes toward Truvada started to change a couple years
ago as doctors, AIDS activists and potential users saw its
effectiveness, he said. The "criticism now is we're not saying
Truvada is helping bolster Gilead's profits as sales of its
biggest moneymakers - treatments for hepatitis C - decline.
U.S. net product sales of Truvada for the first nine months
of 2016 were $1.8 billion compared with $1.5 billion for the
same period in 2015. The company said in its earnings report
that the gain was driven by price increases as well as
"increased usage of Truvada for PrEP."
"We expect PrEP to continue to be a significant part of
Gilead's growth in HIV going forward, particularly in the U.S.,"
Gilead Chief Operating Officer Kevin Young recently told
The new Truvada campaign has been well received, even by
those who once opposed promoting the drug for prevention. They
include David Duran, a writer and HIV advocate, who helped
popularize the term "Truvada Whore" in a 2012 article describing
his fear that it would encourage people to have sex without
Duran began rethinking that concern about a year later in
light of newer research showing that PrEP helped prevent more
cases of HIV, without a rise in other sexually transmitted
disease, which suggested people were using condoms.
"I'm thrilled they are starting to pump some money into
marketing and awareness," Duran said. "There is a solid base of
folks who know about PrEP, but it's still not a topic the
country as a whole knows about."
As a preventive measure, the blue Truvada pill is taken once
daily. Some people experience nausea, vomiting or headaches
during the first few weeks on the drug.
Users must be tested every three months to ensure they don't
have HIV or other sexually transmitted diseases and to monitor
kidney function and bone density.
Some Medicaid programs and most private insurance cover the
treatment, which lists for $1,500 a month before any negotiated
discounts. With greater awareness and favorable coverage for
preventative treatments, the number of Americans using Truvada
could rise, said the company and healthcare providers.
An estimated 50,000 new U.S. HIV infections are diagnosed
The CDC estimated in 2015 that about 1.2 million Americans
were at substantial risk of HIV infection and could benefit from
That includes men who have sex with men, transgender women
who have sex with men, partners of people who are HIV-positive
and intravenous drug users who share needles.
The number of high risk groups "is much broader than one
might think," said Dr. Jennifer Childs-Roshak, president and CEO
of Planned Parenthood League of Massachusetts. "It is not just
men with multiple partners. There are a whole host of folks who
At least 15 patients have gone on Truvada for prevention
since Planned Parenthood's six Massachusetts clinics began
offering it this fall. Planned Parenthood of New York City plans
to offer the treatment to all of its 50,000 patients, said Julia
Sullivan, associate director of quality management.
Wider use also could buffer Gilead when Truvada, the only
drug currently approved in the United States for PrEP, loses
patent protection in 2021. Gilead has a successor treatment in
the works. The once-daily F/TAF (emtricitabine/tenofovir
alafenamide) has been approved for HIV treatment and is under
study as a preventative.
"PrEP is indeed a significant part of Truvada," said Leerink
Partners analyst Geoffrey Porges. "It can certainly keep Truvada
relatively flat but the key question is, when will they show
that TAF works for PrEP?"
In the meantime, the concept of taking an HIV drug to
prevent infection is making inroads in popular U.S. culture. It
came up in an episode of "Transparent," the Emmy award-winning
Amazon series about a family with a transgender parent, when a
character was contemplating sex with an HIV-positive partner.
"We were trying to make the conversation reflect what
happens in real life," said a writer on the show who works under
the name Our Lady J. "PrEP is a big part of that conversation.
As an HIV positive person, I'm struck with the level of
ignorance around PrEP."
(Reporting By Jilian Mincer; Editing by Michele Gershberg and