Evaluating the Current and Future Opportunities for HIV PrEP - Episode 16

Opportunities for Long-Acting PrEP Therapies

Carl Schmid discusses the opportunities and challenges for use of long-acting PrEP therapy among available treatment options.

Carl Schmid: I’m excited about the long-acting PrEP [pre-exposure prophylaxis] drugs. There’s 1 right now and I hope there are going to be more on the horizon. It comes with challenges. You have to go into a clinic or a medical setting of some sort. It has to be administered. It’s a shot. The good news is that you don’t have to take it again until 2 months later. Going into a clinic could be a barrier for some people. Remember that for the oral treatment, you have to go into the clinic every 3 to 4 months as well to get your laboratory tests done. That could be a barrier. To overcome them, make sure pharmacists can administer the drug. Also make sure that there’s more availability and more clinics. If we have these PrEP grant programs throughout the country, I’d want to make sure that they have the ability to administer the long-acting drug as well.

The other challenge that we have is that the United States Preventive Services Task Force hasn’t ruled on the effectiveness of it. They’re undertaking it right now. Once that’s complete, insurers will have another year or so to be compliant. There’s cost-sharing with the long-acting drug right now in private insurance plans. There’s some legislation in the United States Congress to get over these issues to say that as soon as all PrEP drugs are FDA approved, there’s no cost-sharing by any payer and no prior authorizations so that people don’t have to wait several years for it to get that free cost-sharing.

Those are some of the barriers. Hopefully we can get through them and the United States Preventive Services Task Force doesn’t have to do this for every new drug. I hope that they’ll come up with a way to incorporate all new long-acting drugs in their recommendations and that insurers would have to be compliant with that immediately.

People could benefit from a long-acting drug. Not having to take a drug every single day when you’re not sick will help with adherence. It’s much easier. You don’t have to think about it. The adverse effects are extremely minimal, if any. It will help a lot of people who want to go about their lives and not think about taking a drug every single day of their lives. It could also help with people who don’t have stable housing, or perhaps people who use drugs as well, where taking a drug every single day could be difficult.

This transcript has been edited for clarity.