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Ontario will subsidize HIV-prevention drugs — and sooner than you think

‘It’s not free, but it’s now accessible and affordable,’ pharmacist says

A bottle of Truvada, the brand-name PrEP drug used to prevent HIV transmission, is displayed at a pharmacy in California in 2010. Credit: Justin Sullivan/Getty Images

Ontario’s provincial drug program will now cover a drug that protects people from being infected with HIV.

According to the Ministry of Health’s most recent update to the list of drugs it subsidizes, coverage for PrEP starts on Sept 28, 2017.

The pre-exposure prophylaxis drug (PrEP) is a combination of the drugs tenofovir and emtricitabine, which taken daily are highly effective at preventing the spread of HIV.

Until recently, Canadians who wanted PrEP only had access to the brand-name drugs, produced by Gilead Sciences, which cost nearly $1,000 a month.

Generics produced by Teva, Mylan and Apotex cut the costs in Canada by more than half in July, but so far only Quebec has covered PrEP in its drug plan.

Now Ontario’s Trillium Drug Program will cover the generics.

Ontario’s drug program does not cover medications completely; users still must pay a deductible of four percent of their income for all drugs.

That means an Ontarian making $35,000 a year would pay at most $1,400 a year for PrEP, or almost $120 per month once the subsidy comes into effect on Sept 28.

“It’s not free, but it’s now accessible and affordable,” says Michael Fanous, a Toronto pharmacist who has been a key voice in advocating for PrEP coverage.

“Listing emtricitabine-tenofovir on the provincial formulary means that Ontarians without private prescription insurance can now access and afford an expensive but effective medication.”

In cities where PrEP coverage is subsidized or widely available, the rate of new HIV infections have dropped dramatically.

New infections in San Francisco dropped by half in the years after PrEP was approved, and clinics in London, England, have reported 40 percent drops in new infections after large numbers of high-risk men were inducted into a PrEP study.

British Columbia Premier John Horgan suggested he would also cover PrEP in an interview with Xtra before his election in May 2017, but his new NDP-Green government recently said it will wait on lower costs and more research.

Vancouver’s Community-Based Research Centre has launched a campaign to lobby the BC government to cover PrEP.

While PrEP remains unaffordable in many parts of Canada, many gay and bisexual men have resorted to importing cheap international generics through the United States, including setting up an underground buyer’s club to help get the drug to those who can’t afford it.