Most Innovative Companies 2015: A Conversation With Gilead Sciences
Join Fast Company senior associate editor J.J. McCorvey for a live Q&A with Gilead Sciences EVP of corporate and medical affairs Gregg Alton. The event will begin at 1 p.m. ET Thursday, March 12, but you can get your questions in now.

Gregg Alton
Photo by: Photo: Mary Mark Ockerbloom
Gilead Sciences was recently named #16 on Fast Company's Most Innovative Companies list for "developing lifesaving drugs at the speed of need." The biotech powerhouse brought to market a Hepatitis C cure which became the most successful new drug in history.
Join Fast Company senior associate editor J.J. McCorvey as he chats live with Gilead Sciences EVP of corporate and medical affairs Gregg Alton. The event will begin Thursday, March 12 at 1 p.m. ET, but you can get your questions in now using the "make a comment" box below.
And be sure to check out Gilead Sciences' place on this year's Most Innovative Companies list, and read J.J. McCorvey's full feature "How Drug Company Gilead Outpaces Its Competitors--And Common Diseases."

Illustration: Nicolas Berger
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As you said, there's a large number of patients suffering from HCV. Prior to Sovaldi, most of these patients couldn't or wouldn't use the available treatment options. So there was a significant unmet medical need. Without Sovaldi, many of these patients would have no opportunity to be cured and would develop advanced liver disease, cirrhosis or liver cancer.
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We have experience with this from our work in HIV where our Access program is treating nearly 7 million HIV patients in the developing world every day. With HCV, based on these lessons, we start by broadly seeking regulatory approval in all countries throughout the world. In the poorest countries of the world, we price Sovaldi closer to the manufacturing cost at $300/bottle. In addition, we have licensed the rights to manufacture our HCV products to 11 Indian generic companies who have the rights to sell the product in 91 poor countries representing 54% of the global burden for HCV. We also advocate for government funding of hepatitis C at the local level as well as through donor programs.
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I should add that our $300/bottle price sets a ceiling for these countries. The Indian generic companies are free to set their own price. So we expect the price to go down as competition between the 11 generic companies increases.
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The controversy that has surrounded Gilead's pricing gets to a specific issue -- the ability of large pharmaceutical/biotech companies to capitalize on life-saving medicine. (However, you are a for-profit company.) How do you think the rules of innovation change for a company when you're saving people's lives?
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We do have to strike a balance between maximizing profits and pricing at a level that enables access to those who need our medicines. This is different from other industries that may have products that are nice to have, but not necessary for health. This also means that those who pay for the medicine, which varies from country to country, share that responsibility.
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One of the keys to Sovaldi's success was how fast you brought the drug to market availability -- drug development can take up to 10-15 years, but Sovaldi was available to hepatitis C patients within 2 years. Can you lay out your strategy for getting highly effective drugs to market quickly?
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When we acquired Pharmasset, which brought us Sovaldi, we realized very early that we needed to do everything possible to compress development timelines in order to get this important therapy to patients as quickly as possible. This involved our scientists working with regulators to develop comprehensive clinical trials that could provide definitive data in the shortest time. Once we had the data, this involved filing for regulatory approval in the markets with the greatest need. A key component of this is working with health ministries, leading physicians and patient groups. That's something I feel we do well.
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You also have another drug, Truvada, that has become a hot-button issue. It's been shown to be highly effective in preventing the transmission of HIV when taken as a prophylactic, but has also faced resistance by some activist groups. 1) Why do you think some people have protested Truvada PrEP? and 2) With the drug gaining more mainstream popularity, how do you think HIV/AIDS will be perceived 10-20 years from now?
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For the first question, the vast majority of HIV advocates support PrEP. The concern raised by some revolves around increasing risky behavior by those using PrEP and concerns that people won't take the medicine as needed.
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PrEP could play an important role in reducing the number of new HIV infections. Since the beginning of AIDS, significant progress has been made. The number of annual new infections today in most countries is significantly less than 25 years ago. However, we have seen a leveling of the number of new infections over the past 10 years. For example, in the U.S., there are an estimated 40,000 new infections each year. So we need to do more. In addition to PrEP, we also know that we can significantly reduce new infections by diagnosing and treating individuals who are currently not diagnosed. An estimated 90% of new infections are driven by people who are unaware they're infected.
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Does Gilead expect its approach to influence other companies? Will all drugs be developed this way someday?
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We are driven to develop medicine that lets people live longer and better lives. I'm not sure about "forever", but most people do see tremendous value in living longer and healthier lives. This is why we continue to push ourselves to out-innovate our own prior innovation. A good example of this is HIV, where we are driven to develop more potent, but also safer and more tolerable therapies. Another example is fatty liver disease. Now that we have a cure for HCV, fatty liver disease is expected to be the #1 cause of liver transplant by 2020. So we have a number of development programs focused on this disease.
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And I think that'll be our last question -- thanks for being with us today Gregg, and thanks everyone for your participation!
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Thanks very much, J.J. This has been a pleasure. And thanks to everyone who submitted questions.
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Thanks, everyone for coming! For more on Gilead please read J.J.'s excellent feature story:
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How Drug Company Gilead Outpaces Its Competitors—And Common Diseases
Fast CompanyIt can take up to 15 years to bring a lifesaving drug to market. Gilead operates at the speed of need.