Australia Might Finally Make HIV-Preventing Medication Affordable

The life-saving HIV prevention drug Truvada—otherwise known as pre-exposure prophylaxis, or PrEP—will be re-considered for approval under Australia's Pharmaceutical Benefits Scheme (PBS) next week. After failing to be approved by the PBS committee last year, PrEP is currently unsubsidised in Australia. Its users pay around $1000 per month for the antiretroviral pill that has been deemed 99 percent effective in preventing HIV infection.

"Last time PrEP came before the PBS it was considered too expensive," CEO of the Australian Federation of AIDS Organisations Darryl O'Donnell tells VICE. Alongside other HIV advocates, he's been lobbying for PrEP to be subsidised for some time.

"This time there are two manufacturers with applications, Gilead and Mylan. We are hopeful that the competitive tension between them will achieve a lower price, allowing the Pharmaceutical Benefits Action Committee to approve PrEP."

PrEP has been available in Australia for a little while now. The Therapeutic Goods Administration (TGA) approved its importation, sale, and use back in 2016, but because the drug is so expensive it is inaccessible to most. Even at Chemist Warehouse, you'll be paying around $841.69 per month for PrEP, which amounts to $28 per pill. PrEP is however listed on the PBS and therefore subsidised as a treatment for people who have already contracted HIV.

Taken daily, a PrEP pill can dramatically reduce a user's risk of contracting HIV. Used around the world, it provides ongoing protection against infection and therefore significant peace of mind. PrEP differs from post exposure prophylaxis (PEP) which is taken after a potential exposure to HIV—a less desirable way to lower one's infection risk, for obvious reasons.

"PrEP is astonishingly effective and the reality is that we won't end HIV without it. So it's availability on the PBS is critical," O'Donnell explains.

There are currently a couple of PrEP workarounds for Australians who want to dramatically lower their risk of HIV infection without paying $1000 per month. After obtaining a prescription from an Australian GP, it's possible to buy cheaper generic versions of the drug online—but only a three month supply for personal use is permitted by the TGA. And these generic drugs, which can be priced as low as $53 for a month's supply, aren't necessarily up to Australia's regulatory standards.

The other option is to participate in clinical trials run by state governments in New South Wales, Victoria, South Australia, and Queensland. These trials allow eligible individuals free access to PrEP, but to qualify for them people must be considered at "high risk" of contracting HIV. While these trial programmes are invaluable for sexual partners of those who have already contracted the virus, others will have more difficulty accessing them.

For the Australian Federation of AIDS Organisations, increasing the accessibility of PrEP is the first step in completely eradicating HIV from the lives of Australians. The lobby group released a blueprint last week that details how, with extra government funding of just $32.5 million a year, Australia could become the first country in the world to end the transmission of HIV altogether.

"PrEP is really important but it won't end HIV on its own. HIV thrives on stigma and discrimination and many people are still too scared to get an HIV test or seek out medicines such as PrEP. Our blueprint is designed to tackle HIV from every angle, so that gay and bisexual men, people who inject drugs, sex workers and anyone else potentially at risk of HIV has the tools they need to prevent and treat it," says O'Donnell.

The PBS decision will be announced on Friday.

You can find a list of PrEP prescribing doctors in Australia here . The Facebook group PrEP Access Now also provides helpful information for those seeking access to the drug.

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