Descovy® - A new alternative for HIV Pre-Exposure Prophylaxis

Drug Review: Volume 21, Issue 8 - Download PDF

HIV is an incurable viral infection that infects and destroys the cells of the immune system. As the disease progresses, the immune system becomes progressively more compromised, which can result in serious infections and complications. HIV has a significant burden on the quality of life, and work productivity for people living with this disease. The prevalence of HIV in Canada continues to rise, and the ongoing transmission of HIV continues to be a concern in Canada.

The primary goal of HIV management is to achieve maximal and lasting reduction of HIV viral levels in the infected person. By accomplishing this, we can preserve immune function, prevent transmission, and reduce HIV related complications and death. Antiretroviral therapies (ART) are the mainstay of treatment of patients living with HIV. For individuals at risk of contracting HIV, pre-exposure prophylaxis (PrEP) strategies can be used to decrease the risk of transmission. Truvada® is currently the only drug approved for PrEP in Canada. Truvada® is standard therapy for PrEP, however there are long-term safety concerns including kidney and bone toxicities. Therefore, there is an unmet need for an alternative option for PrEP that offers a more favorable long term safety profile.

Descovy® is an ART that has a Health Canada approved indication for the treatment of HIV. Descovy® has also been recently approved for use in HIV PrEP. Descovy® has demonstrated similar efficacy to Truvada® in terms of prevention of HIV transmission, while also demonstrating superiority in terms of long-term kidney and bone toxicity. Descovy® provides an alternative option for HIV PrEP that is both effective and safe.

The annual cost of approximately $9,500 makes Descovy® more expensive than Truvada®. The annual cost of generic Truvada® is $2,665. Descovy® is intended for specific indications and is priced at a premium compared to standard therapy. For this reason, it is recommended that Descovy® be placed under Special Authorization for ClaimSecure groups subscribing to managed formularies.

Drug Name

Descovy®

Drug Ingredients

Emtricitabine/Tenofovir Alafenamide

Annual Cost

$9,527

Coverage Details

Special Authorization for Managed Formularies. Fully covered for Open Formularies.

 ClaimSecure Inc. reserves the right to amend in part, or in its entirety, its Special Authorization guidelines.

References:

  1. Descovy® Product Monograph. Gilead Sciences Canada Inc. 2020
  2. Mayer KH, Molina J-M, Thompson MA, et al. Emtricitabine and tenofovir alafenamide vs emtricitabine and tenofovir disoproxil fumarate for HIV pre-exposure prophylaxis (DISCOVER): primary results from a randomised, double-blind, multicentre, active-controlled, phase 3, non-inferiority trial. Lancet Lond Engl. 2020;396(10246):239-254. doi:10.1016/S0140-6736(20)31065-5