PrEP (Pre-Exposure Prophylaxis) is prescribed to people with a substantial risk of HIV, to prevent HIV infection. The combination preparation emtricitabine with tenofovir disoproxil (brand name Truvada) has been registered for this preventive application. This medicine is also used to treat HIV infection, but in that case always combined with other HIV medicines. In PrEP it is used as monotherapy.
STD test
In addition to medication, a PrEP treatment consists of related care around it. For example, a user must be tested for STIs and HIV every three months and the kidney function is checked. Unlike for the treatment of HIV infection, a prescription for emtricitabine/tenofovir disoproxil as PrEP is not reimbursed by health insurance companies. Based on this payer characteristic, the SFK can distinguish PrEP dispensations from regular HIV medication.
Pilot
In the second half of 2019, a national pilot with a duration of five years started, in which a limited number of people are eligible for subsidized PrEP medication and PrEP care via the GGD. Others can obtain PrEP by prescription from a primary care physician through the community pharmacy.
After an initial increase in the number of PrEP dispensed by community pharmacies since 2018, the number of dispensations has fallen sharply since the start of the pilot. The outbreak of the corona pandemic in March 2020 and the subsequent lockdowns probably also contributed to the decrease. In 2019, pharmacies dispensed PrEP almost 15,000 times, but in 2020 and 2021 this was only about 9,000 times in both years. In 2022, community pharmacies dispensed PrEP almost 12,000 times, 30 percent more than in 2021, but still less than in 2019.
Pharmacies mainly made more initial dispensations in 2022: these increased by 47 percent compared to 2021, while the number of follow-up dispensations increased less rapidly by 25 percent. In total, the SFK will have about 5,000 unique PrEP users in 2022.
By: National Care Guide
Source: Pharmaceutical Key Numbers Foundation