Those big monthly $$s get investors excited tho.
This is to say nothing of the public / private debate.
I mean 225,000 Americans are on it, and multiply that by 1400 x 12, and you're already way past Truvada's global annual revenue. The numbers don't work out.
Americans do subsidize European and African prices though, there's no doubt about that.
There are millions of people with deductibles that are in the $2000 - $8000+ range, and even higher for family plans. Those people are certainly paying $1400 for several months until their insurance kicks in. Then, in the next coverage year, they get to spend that $1400 several times again, and they continue that pattern each year.
If their insurance doesn't cover it, they're also paying $1400.