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Are Truvada Prices An Obstacle to Americans at High Risk for HIV?

AIDS prevention may be revolutionized if healthcare providers start to write more prescriptions for Truvada as a preventative measure for people at high risk for contracting HIV. As reported in the The New York Times, the U.S. Centers for Disease Control and Prevention is pushing for expanded use of Truvada as a prophylactic to prevent new HIV cases. To date, it has been primarily used to treat people who have already contracted HIV. If this recommendation is adopted, the number of prescriptions written for Truvada could increase from less than 10,000 per year to 500,000 per year, hopefully lowering the rate of new HIV infections, which has remained steady at 50,000 per year over the past decade.

But what if patients can’t access Truvada because of its cost? After all, a drug doesn’t work if a patient can’t afford to take it. The drug has a monthly cash price of about $1,500 at local U.S. pharmacies. Fortunately, Truvada is usually covered by insurance and Gilead offers an assistance program that covers the first $200 of a co-pay. They also have a program that covers the full cost of the drug for eligible uninsured or underinsured patients. Eligibility is not guaranteed to all!

Even if you’re insured and prescribed Truvada, the high cost might mean difficulties when it comes time to fill the prescription. Many pharmacy benefit formularies put the drug in tier 2 or 3, which means high co-pays. Other formularies place Truvada on a list of drugs that require pre-certification. In that case, the drug might not even be covered at all!

According to FiercePharma, dramatic increases in the number of prescriptions written for Truvada (and therefore requests for pharmacy benefit reimbursements) could increase co-pays and also curtail assistance programs. If that happens, patients may find themselves having to fork over a lot of cash for higher copays, deductibles or co-insurance. Some may very well end up stuck with a $1,500 per month bill.

For these patients, or anyone else who falls through the cracks, international online pharmacies may be an option. Truvada – the brand – is available for about $543.00 internationally; the generic – emtricitabine/tenofovir – not yet available in U.S. pharmacies, is $224.00. This could provide a lifeline for Americans who are prescribed Truvada in the coming years.

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