Trends in HIV Preexposure Prophylaxis Utilization and Spending Among Individuals with Commercial Insurance
February 29, 2024
In October 2019, Descovy (TAF/FTC) was approved for HIV prophylaxis, following Truvada (TDF/FTC). Descovy, a prodrug of Truvada, was developed to coincide with Truvada's patent expiry, a practice known as 'product-hopping.' Offering only a modest clinical improvement with a 5-year 0.1% increase in QALYs, Descovy’s annual premium of $370 contrasts sharply with the availability of generic TDF/FTC, released in August 2020 at under $1 per pill, compared to branded Truvada ($61) and Descovy ($64) per pill in 2021. This article disaggregates PrEP utilization by formulation in the commercially insured market and estimates excess spending on branded products. It also examines whether 340B Program providers over-prescribe Descovy for higher revenue, as prior commentary suggested.