Your pharmacy can help protect patients from HIV

Get prepped for PrEP

In brief:

• PrEP (pre-exposure prophylaxis) medications help reduce the risk of getting HIV.
• More than 1 million Americans can benefit from PrEP meds — but most patients don’t get them
• Many insurance plans and state Medicaid programs cover PrEP
• Pharmacies can play an important role in helping patients get PrEP

A game changer for HIV

In the effort to halt the spread of HIV, pre-exposure prophylaxis (PrEP) is a game changer for people at risk for HIV. PrEP is a combination of medications prescribed to people who do not have HIV but are at high risk for getting it.

When taken daily, PrEP, an FDA-approved pill made up of two anti-viral medications, reduces the risk of contracting HIV by about:¹

• 99% for those exposed through sex
• 74% for those exposed through injected drug use

Paying for PrEP

Most health insurance plans and Medicaid cover PrEP for eligible patients. Help with co-pays also is available through resources including:

• Patient Access Network Foundation
• Patient Advocate Foundation
• Gilead Advancing Access Co-Pay Card

Ready, set, PrEP

In December 2019, the U.S. Department of Health and Human Services (HHS) launched “Ready, Set, PrEP.” This program is part of the Ending the HIV Epidemic (EHE) initiative. EHE’s goal is to reduce the number of new HIV infections in the U.S. by 75% in 5 years and by 90% in 10 years.

The Ready, Set, PrEP program increases access to PrEP medicines by making PrEP available to those without prescription drug coverage at no cost.²

How pharmacies can participate

Currently, about 1 million people at risk for HIV in the United States could benefit from PrEP medications — which are highly effective — but only a small fraction of these individuals is getting these drugs. Community pharmacies can play a key role in ensuring that the right patients get access to PrEP.

About one third of U.S. chain pharmacies have signed up to participate in the Ready, Set, PrEP program; Health Mart® is the only group of independent pharmacies invited to join this program.

As part of Ready, Set, PrEP, a pharmacy agrees to:

• Receive reimbursement at wholesale acquisition cost (WAC)
• Donate dispensing fees for filling PrEP medications

Also, participating pharmacies need to be ready to counsel patients on adherence. In order to be effective, the medication must be taken daily. Also, remind patients that they must take precautions, such as using condoms, to protect from other sexually transmitted diseases.

There will be no DIR fees or clawbacks related to this program.

Pharmacies in targeted areas identified with the greatest need have been contacted and invited to enroll. The program is expected to roll out to other areas later this year.

Additional resources

Find resources including providers who can prescribe PrEP and brochures for talking with patients on the CDC’s Let’s Stop HIV Together page.

¹“PrEP,” Centers for Disease Control and Prevention,” Dec. 3, 2019.
²“Ready, Set, PrEP Expands Access to Medication to Prevent HIV,” U.S. Department of Health and Human Services, Dec. 3, 2019.