This is a fair point. Negotiated rates are usually lower and the cost should be spread across a pool of insured people, not all of whom have conditions that require ongoing high-cost therapies. Other comments in this thread also point out that there are alternative HIV treatments from Gilead and others that cost less. If the demand is not there for the new monthly injectable, ViiV will suffer for mispricing its own drug.

The standard brand name combination pills come to nearly $20,000 a year for the public insurers in Canada. They really do pay that much.

I'd imagine this cost would generally be borne by insurers or a government health care body.

I don't think either insurers or government health care bodies end up paying the sticker price. They usually have a contracted rate with the pharma companies that is less. Also, pharma companies have patient assistance programs which usually offer major discounts. I really don't know how effective this is and hhow many individuals get stuck with the full bill.

So is the sticker price rarely paid?