6 Resources for Saving Money on PrEP for HIV
Key takeaways:
PrEP, known as pre-exposure prophylaxis, is medication that helps prevent HIV infection.
Under the Affordable Care Act (ACA), nearly all commercial insurance plans, Medicare, and most Medicaid programs cover PrEP with no out-of-pocket costs.
If you are uninsured, there are programs that can help you afford PrEP.
Access savings on related medications
PrEP is a medication that aims to prevent people at high risk of HIV infection from acquiring the virus. It’s an important tool in ending the HIV epidemic.
PrEP is FDA-approved in the U.S. as a daily pill and as an injection administered by a healthcare provider every 2 months after initial shots.
The Affordable Care Act (ACA) requires nearly all commercial health insurance plans, Medicare, and most Medicaid programs to cover PrEP with no cost-sharing. That means you don’t need to meet your deductible for PrEP coverage and won’t have other out-of-pocket costs such as a copay or coinsurance to fill your prescription.
However, paying for PrEP without insurance may be much more challenging. Cost is one reason (among many) why there are racial and gender inequities in PrEP’s use. This disproportionate access is particularly pronounced for people who are:
Here are six resources for saving money on PrEP for people with and without insurance.
What is PrEP?
PrEP is medication that can prevent HIV infection. It is available as pills and injections:
Truvada: This is a daily pill available as a brand name or generic (emtricitabine/tenofovir). According to the CDC, this medication is for people at risk of HIV through sex and IV drug use.
Descovy: This is a daily pill for people at risk of getting HIV through sex. It is not for people assigned female at birth who are at risk of getting HIV through receptive vaginal sex.
Apretude: This medication is a long-acting injection administered by a healthcare provider. It’s FDA-approved for people 12 and older who weigh at least 77 pounds.
Taking PrEP pills or injections as prescribed can reduce the risk of HIV from sex by about 99%.
It’s important to note that HIV affects groups differently, and PrEP is not available to all people equitably (more on this below).
How much does PrEP cost?
As mentioned earlier, you typically have no out-of-pocket costs for PrEP if you have insurance. Coverage also includes the clinic visits and lab tests that are associated with prescribing the medication.
PrEP can be costly without insurance, however. For instance, a 30-day supply of brand-name Truvada or Descovy can cost more than $2,000.
The list price for Apretude was $3,755 in January 2023.
6 resources for saving money on PrEP
Here are some ways you can reduce your out-of-pocket costs for PrEP.
1. Health insurance
Having health insurance can eliminate out-of-pocket costs for PrEP. The ACA requires nearly all commercial insurance plans, Medicare, and most Medicaid programs to cover PrEP without cost-sharing. That means you won’t have to meet your deductible and you won’t have a copay or coinsurance.
Because your status must remain HIV-negative to use PrEP, taking the pills or injections requires lab tests and clinic visits. But you won’t pay out-of-pocket costs for tests, visits, or fills at the pharmacy if you have insurance.
2. PrEP assistance programs offered by states
There are PrEP assistance programs in more than a dozen states and the District of Columbia. These programs:
Provide free medication
Reduce your out-of-pocket costs
May have an income limit
3. Ready, Set, PrEP
Ready, Set, PrEP is a federal government program that offers free medication to people without insurance. You can apply for this program if you:
Do not have health insurance for prescription drugs
Have a negative HIV test result before starting the program
Have a PrEP prescription
Live in the U.S., its territories, or tribal lands
Depending on your income, the cost of your lab tests and clinic visits may not be covered under Ready, Set, PrEP.
4. Copay assistance for people with insurance
Gilead, the manufacturer of Truvada and Descovy, offers a copay card that can save you up to $7,200 per year in out-of-pocket costs for either medication. The program does not cover your cost-sharing for clinic visits or labs. Enrollees in Medicare, Medicaid, and other government insurance programs are not eligible.
Apretude’s manufacturer offers copay assistance for the injections. You can save up to $7,500 a year. People with government insurance do not qualify for this program either.
5. Patient assistance for people who don’t have insurance
If you don’t have health insurance, Gilead’s patient assistance program can help you access free Truvada or Descovy.
If you need help affording the injection, you may be eligible for the Apretude patient assistance program. Your out-of-pocket costs for Apretude could be as low as $0 if you are uninsured and qualify for the program.
6. GoodRx
You can save on PrEP with GoodRx. Generic Truvada can cost you around $30 a month with GoodRx savings.
If I lose my PrEP coverage or savings, is it OK to take a break from taking PrEP until I can afford it again?
You shouldn’t stop taking PrEP without talking to your healthcare provider. If you miss multiple doses of PrEP, you could be at a higher risk of HIV infection.
Is PrEP access equitable?
No. Certain populations are at higher risk for HIV infection, yet have less access to PrEP and lower rates of PrEP use — often due to affordability.
Men who have sex with men are the population most affected by HIV in the U.S. People who are Black, Hispanic/Latinx, and transgender or gender-diverse have disproportionately high rates of new HIV cases but are less likely to have health insurance than white individuals.
It’s important to note that identities can be intersectional, which means a person can be in a racial or ethnic group with less access to PrEP and identify as LGBT. That overlap increases the chance that a person is underrepresented among people taking PrEP prescriptions. The lack of PrEP awareness and culturally competent care also affect equitable access.
PrEP affordability is critical to access for all people in the U.S.
The bottom line
PrEP is a medication that is highly effective at preventing HIV infection in high-risk people. Nearly all commercial insurance plans, Medicare, and most Medicaid programs cover PrEP with no out-of-pocket costs. But if you don’t have insurance, PrEP can be very costly.
In addition to having insurance or using the generic version of Truvada, there are other ways to save on PrEP. You can save on generic Truvada by using GoodRx. You may be able to get free medication through state and federal programs. People with insurance may be eligible for savings through copay assistance programs. If you don’t have insurance and are eligible, you may be able to get free PrEP through a patient assistance program.
Why trust our experts?
References
Centers for Disease Control and Prevention. (2022). HIV and Hispanic/Latino people: PrEP coverage.
Centers for Disease Control and Prevention. (2022). HIV prevention and care for transgender people.
Centers for Disease Control and Prevention. (2022). Paying for PrEP.
Centers for Disease Control and Prevention. (2022). PrEP (pre-exposure prophylaxis).
Centers for Disease Control and Prevention. (2022). PrEP effectiveness.
Centers for Disease Control and Prevention. (2022). PrEP medication guide: Reduce your risk of getting HIV.
Centers for Disease Control and Prevention. (2023). HIV and African American people: PrEP coverage.
Evans, K. N., et al. (2022). The potential of telecommunication technology to address racial/ethnic disparities in HIV PrEP awareness, uptake, adherence, and persistence in care: A review. AIDS and Behavior.
HIV.gov. (2022). U.S. statistics.
Johnson, J., et al. (2022). Building racial and gender equity into a national PrEP access program. Journal of Law, Medicine & Ethics.
Office of Infectious Disease and HIV/AIDS Policy. (2022). Ready, set, PrEP. HIV.gov.
ViiV Healthcare. (2022). Apretude cost and resources.
ViiV Healthcare. (2023). Apretude.
ViiV Healthcare. (2023). What is the list price of Apretude?
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