A pill designed to prevent HIV is now included in Ontario’s public drug plans, signalling a step forward for the LGBT community.
Pre-Exposure Prophylaxis (PrEP), commonly used by gay and bisexual men, became a publicly covered drug on Sept. 28. Other users of the drug include: trans women, women at risk of domestic violence, sex workers, intravenous drug users and people of any gender who have multiple sexual partners.
Without insurance, Truvada, the brand name PrEP drug, used to cost over $1,000 per month. But in July, Truvada’s patent expired and as a result, generic manufacturers were able to start producing the drug. Generic drugs cost 20 to 50 per cent of the retail price of a brand-name drug — between $200 and $500 per month for those without insurance.
Now, Truvada and generics alike are covered, meaning they will be even cheaper. The cost varies according to drug plan. The Ryerson Students’ Union’s health plan, which is available for all full-time students, covers 80 per cent of prescription drug costs.
The new coverage also means that anyone who can write a prescription may prescribe PrEP. Before the change, you could only obtain a PrEP prescription from an HIV specialist.
Christopher Thomas, communications co-ordinator with the AIDS Committee of Toronto (ACT), welcomes the change in law.
“It’s a sign that the province takes this strategy seriously and are willing to invest in it,” he said.
ACT has been pushing for PrEP to be more accessible, and Thomas says the expanded coverage is a step in the right direction.
“The reality is that most people outside of a very locked-in group don’t know what PrEP is,” Thomas said. “We have won the right to access this and that’s definitely something to celebrate, but that was only step one. We need to go back to the drawing board and continue to raise awareness about this.”
According to ACT, one in five gay men in Toronto are living with HIV.
“[PrEP is] something you can keep private if you like and so there’s a lot of potential there for anyone who doesn’t feel able to control their safer sex strategy. It is a really empowering strategy for different groups,” Thomas said.
Zahid Somani, owner and pharmacist with the Village Pharmacy, hopes the coverage changes will help raise awareness about PrEP and HIV prevention.
“I think it’s got people talking,” Somani said. “I’m already seeing more requests for PrEP, more requests for information about PrEP from the general public by telephone and by email. I think the stigma around it is going down.”
Somani has been a pharmacist in the Village area since 1995, and the Village Pharmacy has been open since 2001. In that time, Somani has seen a rise in younger people coming in who were newly diagnosed with HIV.
“Just until two years ago, PrEP was not approved by the government so most of my clients were HIV-positive,” Somani said.
“The hope is that if we treat everyone with HIV and we treat their potential contacts with PrEP, we hope the incidence of new infections will go down dramatically and I think that’s been shown in some studies in the U.S. where PrEP has been available for five years. So that’s the hope. Zero new infections.”
Thomas said there are still structural challenges that need to be addressed in order to make PrEP truly universally available. Issues like being able to retain the PrEP prescription, finding a doctor who you are comfortable talking to, and having a place to store PrEP are all questions to consider.
For young people in Ontario, PrEP will be free starting Jan. 1, 2018 when the OHIP Plus plan comes into effect. This plan will completely cover prescription drugs for anyone who is under 25.