> Cost comes down over time, and more testing occurs over time, somewhat by definition.

Truvada has been around for over twenty years, and generic for 4-5 years. It still costs $2000/month list price.

More testing doesn't just magically happen either. Gilead has chosen for years not to pursue testing, let alone approval, for Descovy in various groups excluded from the original clinical trials. They've decided it's not profitable enough for them. The same could very easily happen with lencapavir, and in fact there's good reason to suspect it will.

Why is it so expensive? And is it covered by insurance? If so, then I'm not sure the list price matters all that much from a 'to most people' perspective, even if there is a moral argument to be had here (in which we'd probably agree).

I'm not entirely sure what the argument is, though - is it just the cynical argument of "well, these companies don't care about solving problems, just profit, so they're never going to do anything with it"? If so, then at least I understand your argument, even if I don't necessarily agree.

But I tend to be an optimist.