Originally intended to be used exclusively by medical professionals and those working in high-risk environments, Truvada (Pre-exposure prophylaxis) was approved by the US Food and Drug Administration for widespread use in July 2012. Several studies have shown that the daily use of Truvada reduced the risk of HIV acquisition, some providing figures as high as 99% prevention rates.
So why aren’t all gay men on this medication?
Truvada is an expensive medication that can cost upwards of $3,000/month for those uninsured or underinsured. However, many insurances do cover a large portion and government programs help to pay out remaining costs keeping copays low. So why are some still hesitant to jump on this prevention regimen?
Claims of alleged side effects
Much of the conversation and initial resistance to taking the pill for prevention purposes surrounded the potential dangers and side effects of this drug. Some reports cited kidney failure and drug resistance, while gastrointestinal bleeding remained a concern to others.
What this new study shows
Researchers from the UCLA school of medicine published a report in the Oxford Journal supporting the claim that Truvada is as safe as aspirin for daily use. They implemented a method that measured the numbers needed to harm (NHH), effectively giving each medication a score on the frequency of reported side effects over five major studies for PrEP and two for aspirin.
The study overall concludes that user safety of PrEP for daily prevention is comparable to the daily use of aspirin. however, the study did point out that further longitudinal studies must be performed to determine the safety of long-term use as a means of HIV prevention.
Gilead’s patent will expire soon
With regard to the astronomical costs of the brand-name version of this drug, Gilead’s patent on the drug used as a method to treat adults already infected with HIV expires on July 25, 2017. It is difficult to distinguish if this also means that the patent for the pre-exposure prophylaxis version (Truvada used as a means of prevention) will expire at this time as well, however it would be surprising if this expiration date was far off. This would mean the creation of a generic cheaper version, increasing accessibility for those who are underinsured and lowering costs for those ineligible for government copay plans that help cover the cost of Truvada.