When taken as pre-exposure prophylaxis (PrEP), daily Truvada or Descovy tablets are about 99% effective at preventing gay and bisexual men from contracting HIV—and likely greater than the current estimate of 88% to 90% effectiveness for heterosexual men and women. A growing body of global research shows that PrEP greatly reduces rates of new HIV cases not just among those taking the drugs but also among those not on it. Unfortunately, misleading ads for personal injury lawyers on social media continue to scare off readers by overstating the health risks of Truvada (which, like Descovy, consists of two meds). What’s more, many care providers still don’t understand—or prescribe—PrEP, and its uptake remains low among minority populations at higher risk for HIV. Luckily, the following changes might address these challenges.
Insurance coverage: As of this year, health insurers are required by law to cover PrEP without charging deductibles and co-payments. That’s because the U.S. Preventive Services Task Force, an independent panel of health experts, gave PrEP an A grade, and the Affordable Care Act requires health plans to cover preventive services that receive an A or B grade.
Easier access: A new law in Colorado allows pharmacists to prescribe PrEP and PEP (post-exposure prophylaxis). And in California, a virtual program at Stanford Children’s Hospital offers PrEP to adolescents and young adults via a cellphone or computer. Clients receive at-home HIV tests (it’s important to be HIV negative before starting PrEP), and they can fill prescriptions at their local pharmacy. “The remote nature…is especially important during COVID-19,” says the program’s director Geoff Hart-Cooper, MD, who adds that the program “offers an added layer of confidentiality, without involving a parent or other guardian if that is the patient’s preference.”
Generic PrEP: Teva Pharmaceuticals’ generic Truvada hit the U.S. market last fall. At $1,455 per month, it’s only a few hundred dollars cheaper than the brand name, but Teva, like Gilead Sciences, which makes Truvada and Descovy, does offer a co-pay card. The real savings arrive this spring, when other companies can begin producing generic versions, which are sold outside the United States for about $25 a month.