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Gilead pays $40m to settle allegations that it delayed work on an improved HIV drug to maximise profits from an older drug

BMJ 2024; 385 doi: (Published 11 June 2024) Cite this as: BMJ 2024;385:q1285
  1. Owen Dyer
  1. Montreal

Gilead Sciences has agreed to pay $40m (£31.5m; €37m) to about 2600 patients who developed kidney and bone diseases while taking its anti-HIV drug Truvada, to settle allegations that the company had already discovered a safer alternative drug but delayed its development and launch for years to extend the profitable life of Truvada.

Gilead dominates the world market in HIV pre-exposure prophylaxis (PrEP) with its blockbuster drug Descovy, based on the molecule tenofovir alafenamide fumarate (TAF). It previously led the market with Truvada, based on the earlier molecule tenofovir disoproxil fumarate (TDF).

PrEP drugs based on TDF are widely acknowledged to have saved millions of lives worldwide, and Truvada is still sold in generic form. But its side effects include renal damage and loss of bone density.

In 2002, the patients have alleged, Gilead discovered a new tenofovir molecule, TAF, that was effective at much lower doses and was likely to cause fewer of these side effects. But the company’s patent on Truvada still had 18 years to run.

As Truvada’s patent neared its end, Gilead became embroiled in legal disputes with several generic …

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