5 Ways to Save on PrEP Costs (With or Without Insurance)

HIV prevention has come a long way in the last decade. While there’s still no vaccine, scientists are getting closer. Until then, PrEP can help. 

PrEP is short for pre-exposure prophylaxis — medication that can cut the risk of getting or spreading HIV. Truvada and Descovy are the only two pills the FDA has approved for PrEP. Studies suggest both are about 99% effective in preventing HIV transmission from sexual exposure. Truvada (emtricitabine/tenofovir disoproxil fumarate) has been on the market since 2012, while Descovy (emtricitabine/tenofovir alafenamide) is newer. 

Unfortunately, PrEP costs threaten to put the drugs out of reach for people who could most benefit from them.

Below, we break down five ways to save on PrEP.

Is PrEP covered by insurance? 

Yes and no. Because PrEP is effective preventive care, the Affordable Care Act (ACA) requires most health plans to cover it at no cost to the patient. 

But reports suggest people with private insurance often struggle with billing issues or coverage obstacles for the medication. They also may face high costs for lab tests and healthcare provider visits to support treatment, even though these costs are supposed to be 100% covered as well. 

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Truvada coverage in particular can be spotty. About 58% of commercial health plans cover Truvada, according to FormularyLookup.com. Some plans have restrictions, such as prior authorizations or step therapy, before you can access the medication. Others may list Truvada on a higher tier, like tier 3. Generally, the higher the drug tier, the higher the out-of-pocket costs for the medication.

Descovy has wider commercial coverage, with about 89% of private plans covering it, compared with 94% of ACA marketplace plans. Medicaid also provides robust coverage, with more than 90% of state Medicaid plans covering Descovy without restrictions. The rate drops to 77% of managed Medicaid plans (think Medicaid HMOs), FormularyLookup.com found.

That said, you may be able to find financial relief close to home. Some states have their own PrEP assistance programs that provide free medication, pick up extra costs, or both. 

How much does PrEP cost without insurance?

PrEP cost without insurance is expensive. The average cash price (the price before discounts or insurance) of a 30-day supply of the most common form of Truvada is $2,022. And the average cash price for a 30-day supply of Descovy is $2,392 for the 200 mg/25 mg dose. 

Source: GoodRx Research

For a year’s worth of medication without insurance, the pharmacy bill could be between $22,000 and $30,000 out of pocket. Fortunately, there are ways to save.

5 ways you can save on the cost of PrEP drugs

Here are some options to consider if you’re having trouble affording PrEP.

1. Copay assistance

Truvada copay card: Manufacturer Gilead’s Advancing Access program offers people with commercial health insurance the opportunity to save on Truvada for PrEP. With a Truvada coupon card, you may pay as little as $0 per month, with coverage of up to $7,200 a year for copays if you qualify. Call 1-800-226-2056 to learn more about the program.

Descovy copay card: Desovy and Truvada share the same manufacturer, so Advancing Access offers the same copay assistance program for both medications. You won’t be eligible if you have government insurance, such as Medicare, Medicaid, or Tricare. But you can still call and explore your options. 

2. Patient assistance program

If you’re uninsured, you may be able to get Truvada for free if you qualify for Gilead’s patient assistance program, also available under Advancing Access.

3. Health insurance appeal

The best way to save on Truvada is to use your insurance and work with your healthcare provider if you’re not satisfied with your options. If Truvada isn’t on your health plan’s formulary (list of covered drugs), ask your healthcare provider about filing an appeal. 

Exact processes differ depending on your insurer. But you likely will have to work with your healthcare provider to include an appeal letter.  

You can find instructions on how to submit an appeal in your health plan’s explanation of benefits (EOB) forms that arrive in the mail or to your secure email account after you receive healthcare services.

4. Generics

For a lower-priced alternative, try Truvada’s generic option: emtricitabine/tenofovir. A GoodRx coupon can help you pay less than $30 for a 30-day supply of the generic — a savings of 99% off the average retail price of generic Truvada. 

5. Ready, Set, PrEP

You can get PrEP medication for free from the U.S. government if you qualify. The Ready, Set, PrEP program  provides access to free daily oral PrEP medication.

To qualify for Ready, Set, PrEP, you must:

• Be without prescription drug coverage 

• Have a negative result from an HIV test before starting the program

• Have a prescription for PrEP

• Live in the U.S. (tribal lands and territories included) 

If you qualify, the first step is to talk to a healthcare provider. You can find a provider who prescribes PrEP at locator.hiv.gov, or you can visit the following sites for no or low-cost care:

• Community health centers

• Sexually transmitted infection or sexual health clinics

• Local health departments

With Ready, Set, PrEP, you can fill the prescription at participating pharmacies and your medication will be free. But depending on your income and where you go for care, you may have to pay a portion of lab test and office visit costs.  

Why trust our experts?

Written by:

Kristen Gerencher, MSOT

Kristen Gerencher is an award-winning writer who has reported on healthcare, medicine, and insurance for a variety of national publications. Before contributing to GoodRx, she was a healthcare and personal finance reporter for MarketWatch.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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Methodology     

This GoodRx cash-price analysis is based on a representative sample of U.S. prescription fills (not GoodRx fills) and comes from several sources, including pharmacies and insurers. 

Reported cash prices are based on average retail prices, the so-called "usual and customary" prices or retail prices at the pharmacy (not including insurance copays or coinsurance). The reported list price is based on the average price a drug manufacturer initially sets. Both cash price and list price listed in this article are based on data from July 31, 2021, to July 31, 2022.  Data for the lowest GoodRx price is the price listed on the website as of August 2022.

The listed copays are from a representative sample of commercial insurance copay charges.

Co-contributors: Diane Li, Trinidad Cisneros, PhD