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Gilead · Emtricitabine; Tenofovir Alafenamide Fumarate

Descovy: invented in a government lab, then Medicare paid $515M for it in 2025

CDC scientists invented the technology behind Descovy, and the government licensed it to Gilead Sciences.
Invented in a government labOrphan drug
Reported

$515M

Medicare paid, 2025

before rebates

Calculated

$3.34B

Medicare, 2020–2025

$17K per patient in 2025

Reported

$114M

Medicare, 2026 Q1

the newest quarter CMS has published

Reported

$470M

Medicaid paid, 2024

before rebates

The public record, link by link

  1. 1 · Public research

    Invented in CDC labs and licensed to Gilead Sciences.
  2. 2 · Patent

    Patents 9044509, 9579333, 9937191, 10335423, licensed by CDC.
  3. 3 · FDA approval

    Approved Oct 3, 2019, sold by Gilead (NDA 208215); orphan-drug exclusivity runs to Jun 20, 2032.
  4. 4 · Public pays

    Medicare paid $515M in 2025 for 30,112 patients; Medicaid paid $470M in 2024.

What Medicare paid for Descovy

Medicare Part D and Part B gross spending by year, before manufacturer rebates.
2020: $558M20202021: $560M20212022: $574M20222023: $590M20232024: $545M20242025: $515M2025: $515M2025

Plus $114M in the first quarter of 2026, for 20,573 patients.

The government license

From NIH Technology Transfer's list of FDA-approved products built on licenses from NIH, CDC or FDA labs.
  • CDC to Gilead Sciences

    Descovy(tenofovir alafenamide plus emtricitabine) is used for pre-exposure prophylaxis (PrEP) to reduce the risk of sexually acquired HIV-1 infection for individuals not at-risk from receptive vaginal sex.

    First sold 2019. Licensed patents: US 9044509, US 9579333, US 9937191, US 10335423. See the list

Gilead's side

Drug makers pay for the clinical trials that take a compound from the lab to FDA approval, and they pay royalties on licensed patents. Those terms are not public. Separately, Gilead received $11M in federal contracts and grants since fiscal 2020, which includes purchases. Gilead's page shows its other products on this list, its federal awards, its PAC's giving and its lobbying. If Gilead wants to add its account, we will publish it here.

How this is built. A product is listed for one of two public records. Either NIH's Technology Transfer office lists it as an FDA-approved product built on a license from an NIH, CDC or FDA lab, or a patent the FDA lists for the drug was reported to NIH as an invention made with NIH grant money, as the Bayh-Dole Act requires. We then add what Medicare Part D, Part B and Medicaid paid for each product, and for each company, the federal grants and contracts it received, its PAC's donations and its lobbying.

What the numbers mean. Medicare and Medicaid figures are gross spending before the rebates drug makers pay back, which are confidential. Hospital-administered therapies such as CAR-T cell treatments are mostly paid under Medicare Part A and do not appear in these files. "NIH grants" is everything NIH paid on the grants a patent was reported under, from 1985 on; a grant usually paid for more than one invention, so it is not the cost of the drug. Federal contracts include purchases, such as vaccine doses, as well as research. Companies also paid for the clinical trials that took these products to approval. None of these figures shows that public money set a price or bought a decision.

Sources: NIH Technology Transfer: FDA-approved products licensed from NIH, CDC and FDA labs; NIH RePORTER patents reported under NIH grants (from iEdison); NIH RePORTER project funding; FDA Orange Book patent, exclusivity and product files; CMS Medicare Part D and Part B Spending by Drug (annual and quarterly); CMS Medicaid Spending by Drug; USAspending.gov federal grants and contracts. Updated 2026-11-06.