that Gilead set prices high in disregard of the human cost and in order to set the stage for a higher eventual price for Sovaldi's successor, Harvoni. The committee's investigation, based in part on internal documents obtained from Gilead, revealed that the company had considered prices ranging from $50,000 to $115,000 per year, trying to strike a balance between revenue and predicted activist and public relations blowback, with little regard to research and development costs. The high prices forced state Medicaid programs to ration treatment to patients, delaying treatment of less advanced hepatitis C cases. In Oregon, for example, 10,000 Medicaid patients were deemed good candidates for Sovaldi therapy, but the Oregon Health Authority estimated that treating half of these patients would more than double the state's total drug expenditures. The state thus opted to limit treatment to 500 patients per year. Truvada and Descovy Truvada was introduced to the market by Gilead in 2004 to treat HIV infections. In the following years, the United States government conducted research demonstrating that Truvada was able to prevent HIV infection. The US Centers for Disease Control holds the patent for this use of Truvada as pre-exposure prophylaxis (PreP). Gilead introduced Truvada for PreP in 2012, at which point a prescription cost approximately $1,200 per month in the United States. By 2018, this price had increased to up to $2,000, despite generally costing less than $100 outside the U.S. Gilead made over $3 billion in sales of Truvada in 2018. The high price drew the ire of activist groups such as ACT UP and was the subject of a Congressional hearing in May 2019. Gilead's CEO defended its pricing in the hearing by noting the large sums the company spends on HIV/AIDS research. Activists pressured the US government to enforce its patent on Truvada in order to combat the high prices set by Gilead. In May 2019, Gilead announced it would donate enough Truvada to treat up to 200,000 patients annually for up to 11 years, the result of discussions with the Department of Health and Human Services under Trump. Dr. Rochelle Walensky noted that the donations still covered less than one-fifth of the people who need the drug, and argued it was possibly a move to help the company market Descovy, a more advanced successor drug. Walensky led a 2020 study that concluded the high costs of Descovy would on the whole