Image credit: NIAID
PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis) have been life-changing for members of the community, and if a bill in the California Senate gets passed, it could change the lives of even more people.
According to a report by Capitol Public Radio, a bill authored by San Francisco Senator Scott Wiener and co-authored by San Diego Assemblyman Todd Gloria would make limited amounts of PrEP and PEP available over the counter.
PrEP is a treatment system that prevents HIV infection through a pill taken once a day. PEP, on the other hand, is a course of HIV medications taken within 72 hours after possible exposure. Both PrEP and PEP require prescriptions and sometimes even approval from insurance companies before doctors can even write the prescriptions. If the bill is passed, patients no longer need those requirements.
If the bill becomes law in California, patients will only need to be tested for HIV a week before they plan on purchasing PrEP. Pharmacists are required to inform them of the possible side effects, as well as to inform the patient’s primary care provider. Patients can also get a 30-day supply of the treatment.
The bill is yet another step in making PrEP and PEP available to the people who need them most. Earlier this year, the Centers for Disease Control and Prevention partnered with pharmaceutical company Gilead to make 2.4 million bottles of Truvada available to them over the next 11 years. Teva Pharmaceutical is also set to release a generic version of Truvada in 2020. Just two months ago, the United States Prevention Services Task Force (USPSTF) gave PrEP a Grade A recommendation, meaning private insurers are now required by law to pay for PrEP.
Adam4Adam blog readers, especially the ones living in California, how do you feel about this bill? Share your thoughts and opinions with us in the comments below!
Nathan writes: I applaud the distinct reality that PrEP & PEP will be available over-the-counter. However, as seemingly always, it will remove a certain responsibility to the sexually-active, to take personal responsibility for their sexual activities. Preventing one, distinct, socially-transmitted-disease, is admirable, however, it encourages the continued sexual practices of other socially-transmitted-diseases; it is the “proverbial” catch-22: prevent one thing but, either, encourage or lessen the realities of another thing. The problem still remains that the responsibility of a sexually-active person remains and is to be noted and respected. Certainly, there will be those who will continue their responsibilities to… Read more »
“Preventing one, distinct, socially-transmitted-disease, is admirable, however, it encourages the continued sexual practices of other socially-transmitted-diseases; … ”
That statement presumes that all STIs are “equal”. But, in reality, a small uptick in Gonorrhea is a small price to pay if the result is a significant decrease in HIV.
You are also making the assumption that before they went on PrEP, the guys were using condoms. But, many weren’t. They were just going without any protection whatsoever.
BARRY-NJ:
Most Americans did not use condoms back-in-the-day; neither in Vietnam nor America. American soldiers were warned of a extremely virulent “Gonorrhea” which was resistant to virtually any anitbiotic, then, available.
Many American Soldiers had their “Urinary Meatus” eaten away by this “Gonorrhea” and had to have a part of the penises amputated.
You like democracy? Lets have a nation wide vote on issues such as homosexuality, transgenderism, etc., and we’ll see just how much democracy pleases you. This “democracy” that so many people like to drone on about is, in it’s pure form, nothing more than mob rule. The USA is a constitutional republic with some elements of democracy limited by the constitution. It is a quite brilliantly conceived arrangement that was set up by all those racist old white men so many years ago because they had a good understanding of the evils of democracy. It is not democracy that prevents… Read more »
I think this would’ve been amazing years ago as an over the counter medication offered I think that it would be really great but I sort of I’m concerned that is it going to enable game in to really wore out because of all the open relationships and nonsense that they think that there like entitled to do getting around getting it in with multiple days and again commenting on any topic related to this this is the reason esp HIV and (other STDs) have spread like they have since the early 80s But it is a really great weapon… Read more »
I live in Cali and am excited that the passing of this bill is becoming an reality! Many ppl can’t afford PrEP/PEP.
A excellent move in the right direction!!
I wouldn’t expect any sudden price reductions. Why would Gilead give up any profits? In fact, as others have pointed out, there may be issues because many insurance companies don’t cover OTC medications (although, some do if the medication is obtained with a prescription).
Hopefully, the real advantages will come by 2021. Six months after the introduction of the first generic (in 2020), other generic houses can start producing generic Truvada, too. That’s when we’ll see significant price reductions.
This ^
Praise… now waiting on an over-the-counter cure for herpies and hiv
wouldn’t surprise me if insurance companies were behind this; they don’t cover OTC meds.
I agree. So, even if Gilead lowers the price a little bit, the insurance companies are off the hook. For an example, look at antacids like Zantac, which used to be available by presription.
Exactly. And a source of federal funding for the uninsured (340b) would disappear too if the drug is over the counter. Really bad idea.
There is a reason we do frequent blood tests while on these meds. Making prep OTC is a political talking point, not a medically sound decision.
Not to mention resistances that develop from starting / stopping medication, etc etc etc.
This is politics, not medicine. People won’t be better served by this.
“Not to mention resistances that develop from starting / stopping medication, etc etc etc.” PrEP is taken by people without HIV. There is no underlying disease that can gain resistance. Of course, there are risks if someone stops PrEP and then has sex, but that’s a different issue. If I abstain from sex, there’s no problem with starting/stopping PrEP as often as I want. And, making PEP available without a prescription is a great advance. There are undoubtedly many guys who are put off by the requirement to go into an ER or try to get an appointment with their… Read more »
For the gay men that only think with their “smaller head” be Warned. READ the side affects from Truvada. Listen to the TV ads WARNINGS of possible SIDE EFFECTS – “Bone Breakage” – sounds less harmful than saying AVN -Avascular Nicrosis -a Hideous side effect that restricts blood flow to the Bone Joints and they CRUMBLE. ‘Kidney problems” sounds less SCARY than KIDNEY DISEASE. They are NOT pitching PREP to young STRAIGHT people just as Sexually Active. Gay people are still considered to be of Less Value than Hetros and make great GUINEA PIGS. Making this drug available over the… Read more »
I’ve taken PrEP for 10 years and have nothing of what you mention. Of course if you eat McDonalds and drink Pepsi all day long, it’s possible, but I eat very well, take supplements of vitamins, do lots of sports and gym, I dont drink or take drugs and my health is great! I guess it’s all about what you put the blame on.
Diet does have a lot to do with over-all health. However, Dave, Santino does raise some valid points, I have myself, read about-heard about these side-effects that men are suffering from of their meds. I keep saying, “keep yourself out of the hands of these pharms in the first damn-place” it’s like being gang-banged over and over again, the pharms are just passing you along to each other, getting wealthier all the time, ’cause folks can’t-won’t glove-up, use more discretion-using better judgement…
yeah I hear it too, some of my friends had problem… but you can stop if you body doesnt react well. My best friend do cycles…
This bill if passed will be wonderful especially to those who do not have my medical insurance. Gilead should be able to provide free PrEP based on the company’s profits.
So now instead of my insurance paying for it, I would have to pay for it??
Yes. When a med goes over-the-counter (OTC), the insurance companies no longer have to pay for it. I doubt Gilead will give out the brand version for free. The good news is that the generic version will be available soon… and that usually results in lower prices from free market competition.
you know this is not a good thing, some people dont have the brains they were born with. this would allow the manufacturers to charge whatever they wanted because they would not be under the atf rules anymore because they would be otc products. Your insurance would not pay for them and they would be so expensive on the desperate could afford them
Ummm, okay. Can we have funding for education on how this works so at-risk persons understand? Is this going to be made available in Brazil and countries in Africa so that those suffering and dying are protected? Making it available OTC only in the US is a step, but not yet enough. Signed, an educator and health professional (gay and HIV neg, but still concerned about all of humanity)
The headline is misleading. They’re talking about the California Senate, not the federal senate, so the OTC change would only be in that state unless other states follow their lead (which I expect will happen).
If Brazil and other countries wish to make the drug OTC, that is up to them. PrEP is already remarkably cheap in many developing countries.
Finally. Don’t want to “soap box” this too much, but think it’s a good idea…and when are we going to get universal health care? “Cause everybody just loves their insurance companies, right?
We (USA) already have universal health care. If you don’t believe me, the the next time you are sick or injured go to a hospital ER. They are bound by law to treat you if necessary. (Ronald Reagan signed that little tidbit into law.) You can even ignore the bills the hospital will send you. I know a guy who does it all the time. Of course, he’s not worth suing anyway so there’s that. Still want socialized medicine? Go explore the wait times to get treatments and surgeries in Canada or England. A person could die waiting for an… Read more »
Ugh, such a BAD idea. Truvada is such a horrible medication! I’ve been on it for over 6 years. I’m pretty sure I have major bone density loss and kidney issues. I know people that have been on it for less, have been tested for BOTH and have confirmed issues in both realms. Gilead is being sued in multiple different cases for both downplaying the potential side effects AND for withholding BETTER less harmful medications willfully so they can milk the cash cow that is Truvada. We need to focus on suing Gilead and forcing them to make the better… Read more »
You’re “pretty sure”? You’re making assertions about the side effects of the medication and you don’t even know if you’ve been affected? And, if you’re so concerned, why are you apparently still on it?
The question is HOW MUCH will OTC ( over the counter ) Prep and Pep cost? My prediction is Astronomical, and unaffordable for most California’s citizens.
My concern about a bill like this, if it’s even a real thing, is that prescription drug benefits do not cover over-the-counter medications. Unless the bill addresses that issue, an OTC version of Gilead’s Truvada will likely cost around $600-1,000. If and when Teva comes out with a generic, and I believe 2020 is a highly optimistic outlook on that, they’ll be allowed to charge whatever they want for it. I don’t think people ought to be treating themselves acutely, on a month-by-month basis, for HIV prevention, and the medication(s) used for this should remain on prescription so it is… Read more »
my insurance company (the one with the big rock) is self-insured and can pick and choose what meds it pays for. this year they are using a new mail-order pharmacy and I am having trouble getting almost every rx,,, they find a reason to deny it, delay it, change it or not automatically refill it. hope it works in CA