• Both Truvada and Descovy are approved for purposes of HIV prevention (PrEP)
• Truvada (Tenofovir disoproxil fumarate/emtricitabine) now has a generic version. More companies are likely to offer the generic by the end of 2021
• Descovy and Truvada have pros and cons
• The medication, Truvada, and the generic Truvada form seem to have similar clinical effectiveness
• There may be more barriers to obtaining a specific medication through certain insurance carriers as they are developing their own policies. So plan ahead to avoid interruption of care.

This year, Teva Pharmaceuticals have launched a generic version of Truvada, a HIV medication that is used for both HIV treatment and prevention. HIV Pre-Exposure Prophylaxis (PrEP) refers to using a medication before exposure to reduce the risk of acquiring HIV. Truvada through Gilead has been the only FDA-approved medication until Descovy was approved. Descovy has come with an increased safety profile to the kidney and bones. There are certain circumstances where it may be better to use Descovy over Truvada for the purposes of PrEP. However, both remained fixed at a high price of almost $2000 per month to be on the medication.

Insurance coverage for PrEP medications has also fluctuated since 2014. In 2015-2017 many insurance carriers required extensive paperwork and prior authorization to fill the medication, likely due to its cost. Patients with no insurance could go through a program with Gilead to have some assistance. The administration burden made it hard to efficiently deliver the medication to a lot of patients. Luckily, the stringent insurance requirements lightened up between 2017 and 2020. Would this continue now that we have a new player in the market?

Tenofovir disoproxil fumarate/emtricitabine is the combination of active medications found in Truvada. Teva Pharmaceuticals has marginally undercut Gilead in their pricing of the medication. However, this change has already resulted in some insurance companies, such as United Healthcare, adding a layer of paperwork when a physician tries to prescribe Descovy to a patient instead of Truvada or the generic Truvada version. Both patients and clinicians need to be aware of this to avoid periods of interruption of treatment. Hopefully with the addition of more generic Truvada offerings in the market, Tenofovir disoproxil fumarate/emtricitabine would be affordable to offer on wholesale price to patients with insurance lapse or no coverage efficiently.

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