An effective but expensive treatment to prevent the transmission of HIV is proving difficult for some Albertans to access.
Truvada is a prescription medication which had initially been used as a treatment for HIV. After further research, it was discovered the drug could be used as a form of pre-exposure prophylaxis (PrEP), or preventative treatment, when taken daily and used in conjunction with safer sex practices. Studies show Truvada is 95 to 99 per cent effective in preventing the transmission of HIV.
The biggest hurdle for those attempting to access Truvada is cost.
“In Alberta, a PrEP prescription out of pocket is probably going to cost about $800 to $900 (per month),” said Andrea Carter, director of programs for HIV Community Link. “It is currently not covered under the public provincial drug plan.”
In 2016, the national Common Drug Review recommended the provinces add Truvada to the public drug benefit list (formularies) provided it is dispensed through a sexual health program and that the cost of the drug comes down.
“We need to make sure we’re working together with our partners across the country to be able to get the best price possible for the drug for Albertans,” Associate Health Minister Brandy Payne said.
“Unfortunately, I don’t have an update today on the timeline (for public drug benefit coverage). It is something we are hearing from our partners in community organizations and across the province that this is a priority.”
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On July 26, Health Canada approved applications by three companies to manufacture a generic version of Truvada. Those products bear some version of the name Emtricitabine/Tenofovir disoproxil fumarate — the two elements which make up Truvada.
Teva Pharmaceuticals told Global News its generic version of Truvada started to be shipped across Canada last Thursday, with the drug expected to be available within the “next several days.”
“In Canada, when a generic first comes to market, it’s usually at about 70 per cent of the original cost,” Carter said. “It will certainly encourage the process of getting it on the public formularies.”
In a statement to Global News, Teva said pricing for the drug is under review.
“The Teva Canada product will be less expensive than current brand pricing. Pharmaceutical pricing is highly regulated in Canada and the Pan Canadian Drug Alliance establishes prices for products covered by provincial formularies.”
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Carter said some private health benefit plans cover the cost of Truvada, but that access through those means is hardly universal.
“Unfortunately, it’s not very clear which private plans (or) which providers will cover part or all of a PrEP prescription,” Carter said. “I know some people in Calgary who will be with ‘Company A’ and have 100 per cent coverage. Other people are also with ‘Company A’ and have 50 per cent coverage. And, another person with ‘Company A’ has zero coverage.”
Those who are in a relationship with a partner who is HIV-positive, engage in sex with those of unknown HIV status, have multiple sex partners, or have been diagnosed with other sexually transmitted infections in the past six months are all considered at a high risk for HIV transmission and could be candidates to take Truvada.
In 2016, there were 282 new HIV infections in Alberta. Carter believes better access to Truvada would result in fewer cases in the province.
“If people at highest risk have an option to prevent HIV, that’s going to make a big difference.”