Why Lenacapavir is Important … and Expensive

Injectable lenacapavir, the investigational twice-yearly antiretroviral, has created quite the buzz this year, reporting an almost 100% success rate at preventing HIV in clinical trials, when compared to placebo. However, this success comes with a price, up to $44,819 per person per year, according to an article published in the Journal of Antimicrobial Chemotherapy.

This price tag is expected to cause access issues, according to Jose Abrigo, Esq., HIV Project Director of the Lambda Legal Defense and Education Fund.

“Insurers are disincentivized to cover really expensive drugs,” Abrigo said in an interview with Managed Healthcare Executive. “Because insurance companies don't want to spend money, if there is a viable alternative, they will deny it and say, ‘take the others.’ That analysis isn't fully informed sometimes because sometimes the medical records submitted to them are incomplete, doctors don't know how to word the request and just the default for most insurers to deny.”

Lenacapavir is already FDA-approved for patients with drug resistant HIV, under the brand name Sunlenca.