agreed to fund wider access to all of the pharmaceutical company's cystic fibrosis medications that were already licensed at that time, such as Orkambi, Symkevi and Kalydeco, and any future indications of these medicines. The funding agreement was finalized soon after Vertex signed reimbursement deals elsewhere, including NHS Scotland, Spain and Australia. The NHS in Wales and Northern Ireland will be offered equivalent pricing terms. On June 30, 2020, Vertex and NHS expanded the agreement to include reimbursement of Kaftrio, making CF patients in England to be among the first in Europe to access public funding for this medicine upon its approval by the European Commission. By October 2019, Vertex's CF medicines were publicly funded in 17 countries. Venture philanthropy In the late 1990s the Bethesda-based Cystic Fibrosis Foundation, encouraged by then-President Robert Beall, began investing in Vertex— when it was a small start-up biotechnology company— to help fund the development of Kalydeco in the form of venture philanthropy. The total investment amounted to $150 million. In 2014, the CF Foundation sold the rights to the royalties of the drugs for $3.3 billion, twenty times the foundation's 2013 budget. Proponents of venture philanthropy say the high financial return helps speed drug development and also provides potential monetary rewards that can go to more research. By 2015 the annual price of Kalydeco had been increased to more than $300,000 per patient. According to an article published in the Milwaukee Journal Sentinel Vertex executives "grossed more than $100 million by cashing in stocks and stock options" and at "one point, the value of company's stock increased more $6 billion in a single day." Twenty-nine physicians and scientists working with people with cystic fibrosis (CF) wrote to Jeff Leiden, CEO of Vertex Pharmaceuticals to plead for lower prices. The company responded in an email that "while publicly funded academic research provided important early understanding of the cause of cystic fibrosis, it took Vertex scientists 14 years of their own research, funded mostly by the company, before the drug won approval." On 15 April 2015 in Cambridge, Massachusetts, Joan Finnegan Brooks of the Cystic Fibrosis Foundation spoke about the role of Vertex and venture philanthropy to a panel of biotech leaders hosted by Life Sciences Foundation on the topic of patient advocacy in the biotech industry. While Brooks, who has cystic fibrosis, expressed gratitude for Vertex's development of Kalydeco, she observed that "More than