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Chains supporting expanded access to HIV drugs

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WASHINGTON — Walgreens, CVS Pharmacy and Rite Aid Corp. have donated dispensing services for the Department of Health and Human Services’ (HHS’) new program expanding access to medication to prevent HIV. Beginning no later than March 30, as part of these donations, qualified patients can obtain medications for pre-exposure prophylaxis (PrEP) at more than 21,000 combined Walgreens, CVS and Rite Aid locations throughout 50 states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands or through mail order — all at no cost to patients.

The pharmacies represent about a third of all prescription counters in the country. All three retailers will also provide patient counseling and take steps to promote patient adherence to the regimen.

“Walgreens has supported people living with HIV/AIDS since the beginning of the epidemic more than 35 years ago,” said Glen Pietrandoni, the chain’s senior director of patient care and advocacy. “Over time, we’ve built close relationships with various HIV advocacy groups and community organizations to help support people living with the virus and further our commitment and reach to prevent the virus from ­spreading.”

“With effective HIV treatment and prevention options through new medications, we firmly believe that pharmacists are uniquely positioned to educate and support people at risk and those living with HIV directly in the communities that they serve,” added Pietrandoni. “As a resource and as part of a patient’s care system, pharmacists can play a key role in helping to end the epidemic. By participating in the Ready, Set PrEP program, we’re now able to dispense free HIV medications to qualifying individuals who don’t have insurance. This complements our efforts to raise awareness for effective prevention options and making them available to all of our patients, regardless of their socioeconomic status.”

Walgreens has trained its pharmacy staff to be a resource for HIV preventative care, as well as for patients living with HIV. More than 3,000 trained HIV-specialist pharmacy staff are at over 1,000 Walgreens stores, and many of them are in areas with a high incidence of HIV, as defined by HHS. These pharmacists offer nonjudgmental, confidential, one-on-one medication counseling to support people impacted by HIV and treatment adherence, and help in other ways, such as identifying co-pay assistance options. Adherence to treatment is particularly important to ensure the effectiveness of HIV medications. “Our pharmacy staffs support adherence by reaching out to patients proactively should they fall behind their refill schedule,” Pietrandoni said.

Currently, there are only two FDA-approved medications for PrEP. Both are combinations of two anti-HIV drugs in a single pill:

• Emtricitabine and tenofovir disoproxil fumarate, sold under the brand name Truvada by Gilead Sciences Inc.

• Emtricitabine and tenofovir alafenamide, sold under the brand name Descovy, also by Gilead.

Truvada is approved for PrEP for all adults and adolescents at risk of HIV. Descovy is approved for PrEP for some adults and adolescents, but it is not approved for those who are at risk of getting HIV through receptive vaginal sex because effectiveness in this population has not been evaluated.

Generic versions of the drugs are not available in the U.S. While the patents and exclusivity for tenofovir disoproxil fumarate have expired, the patent for emtricitabine expires in 2021. However, in May, Gilead announced that a generic version of Truvada is expected to be made available in the U.S. one year early — this coming ­September.

“We know there is an urgent need to expand uptake of PrEP as an HIV prevention strategy among those at risk for HIV in the U.S.,” said a Gilead spokesman. In recognition of this need, the company is providing input and support to HHS in its efforts to ensure an expeditious launch of the Ready, Set, PrEP.

“We are excited about the potential of this program to reach even more uninsured people in the United States who are at-risk of HIV and could benefit from PrEP, particularly those in underserved and heavily impacted communities,” the spokesman added.

Although more than 1 million people at risk for HIV in the United States could benefit from PrEP medications, only a small fraction get them. The Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force exit disclaimer icon recommend PrEP for individuals at risk of acquiring HIV. When taken as prescribed, PrEP is highly effective at reducing an individual’s risk of acquiring HIV.

Ready, Set, PrEP is a key component of the Ending the HIV Epidemic: A Plan for America (EHE) initiative. EHE aims to reduce the number of new HIV infections in the United States by 75% in five years and by 90% in 10 years. By increasing awareness of PrEP and its access, the Ready, Set, PrEP program can provide thousands of people a safe, effective way to prevent HIV and bring the nation one step closer to ending the HIV epidemic.

“Ready, Set, PrEP is a historic expansion of access to HIV prevention medication and a major step forward in President Trump’s plan to end the HIV epidemic in America,” said HHS Secretary Alex Azar. “Thanks to Ready, Set, PrEP, thousands of Americans who are at risk for HIV will now be able to protect themselves and their communities. The Trump administration recognizes the vital role of prevention in ending the HIV epidemic in America, and connecting members of vulnerable communities to prevention services and medication is an important part of the president’s initiative.”

“PrEP is highly effective in preventing HIV infection when taken as directed,” said assistant secretary for health Dr. Brett Giroir. “It is a critical tool for ending the HIV epidemic, but to make an impact it has to be available for people who need it most. Ready, Set, PrEP will increase access to this effective and preventive drug for people at risk.”


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