Rep. Alexandria Ocasio-Cortez, D-N.Y., didn't hold back Thursday in questioning the chief executive of the company that makes Truvada about the high cost of the drug used to prevent HIV with pre-exposure prophylaxis, or PrEP.

"The list price is almost $2,000 in the United States. Why is it $8 in Australia?" Ocasio-Cortez asked the CEO of Gilead Sciences, Daniel O'Day, after noting the company made $3 billion in revenue off the once-a-day pill in 2018.

O'Day responded that "Truvada still has patent protection in the United States, and in the rest of the world it is generic." He noted that, as announced last week, the drug is set to be generically available in the U.S. in September 2020.

“There’s no reason this should be $2,000 a month," Ocasio-Cortez, who has pushed for the hearing before the House Committee on Oversight and Reform. "People are dying because of it, and there’s no enforceable reason for it.”

Ocasio-Cortez also claimed, as has been alleged by activists and academics, that Truvada’s use as an HIV prevention pill was discovered by the U.S. government.

"We the public, we the people, developed this drug, we paid for this drug, we lead and developed all the grounding patents to create PrEP, and then that patent has been privatized despite the fact that the patent is owned by the public, who refused to enforce it," Ocasio-Cortez said.

In prepared remarks, O’Day denied the charge that the Centers for Disease Control and Prevention, part of the Department of Health and Human Services, owns the patent for PrEP. ”Every single Gilead employee is proud that we invented Truvada, a medicine that can both treat and prevent HIV,” he said.

“Our well-supported view is that the U.S. government does not hold valid patents on the use of Truvada for pre-exposure prophylaxis, nor does it hold any patent for Truvada itself,” O’Day added.

The hearing came as activists have ramped up pressure against Gilead, a company that commercializes and manufactures a variety of therapies and cures for chronic diseases.

Members of the PrEP4All Collaboration, a group of activists pushing for broad PrEP access, and legal experts filed a class action lawsuit on Tuesday alleging that the nation’s largest HIV drug manufacturers, including Gilead, for years conspired to keep cheaper generic component medications out of popular “combination pills” that make treating HIV as simple as taking one pill a day.

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