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PrEP Medicines
Although there is currently no effective vaccine for HIV, medical researchers have been tirelessly working to protect people from the threat of AIDS. Over the years, significant progress has been made, leading to the development of several effective Pre-exposure Prophylaxis (PrEP) medicines that can significantly reduce the risk of HIV infection. The advent of PrEP marks a critical milestone in the fight against AIDS. When taken as prescribed, these medications can provide a level of protection similar to that of a vaccine, greatly reducing the risk of contracting HIV.
Truvada
Truvada, developed by Gilead Sciences, was first approved in 2004. It is the first medicine approved for use as PrEP and is widely used globally.
Composition and Dosage
- Emtricitabine: 200 mg
- Tenofovir Disoproxil Fumarate: 300 mg
Effectiveness/Target Population
Truvada works by blocking a key step in the HIV replication process. It is suitable for high-risk populations, including men who have sex with men (MSM), heterosexual couples, partners of HIV-positive individuals, and injection drug users.
Form and Administration (How to use )
Oral tablet taken once daily. With or without food.
How much does Truvada cost?
Approximately $1500 to $2000 per month, though subsidies are available in some countries.
Regulatory Approval
- World Health Organization (WHO): Recommended for HIV prevention
- U.S. Food and Drug Administration (FDA): Approved in 2012 for PrEP
- European Medicines Agency (EMA): Approved in 2016
- Japanese Ministry of Health, Labour and Welfare: Approved in 2016
- Chinese National Medical Products Administration (NMPA): Approved in 2019
- Taiwan Food and Drug Administration (TFDA): Approved in 2017
- Hong Kong Department of Health: Approved in 2018
- Singapore Health Sciences Authority (HSA): Approved in 2018
Generic Truvada Medicines
Several generic versions are available on the market, including:
Generic Medicines Certification
Generic versions by companies like Mylan have received FDA, WHO, and EMA certification.
Descovy
Descovy, also developed by Gilead Sciences, was approved for PrEP use in 2016. It is an improved version of Truvada.
Composition and Dosage
- Emtricitabine: 200 mg
- Tenofovir Alafenamide: 25 mg
Effectiveness/Target Population
Compared to Truvada, Descovy has fewer side effects on the kidneys and bones, making it suitable for individuals with sensitive constitutions. It is appropriate for all who meet the criteria for PrEP use, though it is not yet approved for preventing HIV infection through injection drug use.
Form and Administration
Oral tablet taken once daily. With or without food.？
How much does Descovy cost?
Approximately $1600 to $2200 per month.
Regulatory Approval
- World Health Organization (WHO): Recommended for specific populations for HIV prevention
- U.S. Food and Drug Administration (FDA): Approved in 2019 for PrEP
- European Medicines Agency (EMA): Approved in 2019
- Japanese Ministry of Health, Labour and Welfare: Approved in 2019
- Chinese National Medical Products Administration (NMPA): Approved in 2020
- Taiwan Food and Drug Administration (TFDA): Approved in 2020
- Hong Kong Department of Health: Approved in 2020
- Singapore Health Sciences Authority (HSA): Approved in 2020
Generic Descovy Medicines
Currently, no generic versions are available.
Apretude
Apretude, developed by ViiV Healthcare, was approved in 2021. It is the first long-acting injectable PrEP medicine.
Composition and Dosage
- Cabotegravir: 600 mg
Effectiveness/Target Population
As a long-acting injectable, Apretude provides a convenient option for those who prefer not to take daily oral medications. It is suitable for all high-risk populations, including MSM and heterosexual individuals.
Form and Administration
Injection once every two months.
How much does Apretude cost?
Approximately $20,000 to $24,000 per year.
Regulatory Approval
- World Health Organization (WHO): Recommended for HIV prevention
- U.S. Food and Drug Administration (FDA): Approved in 2021 for PrEP
- European Medicines Agency (EMA): Approved in 2022
- Japanese Ministry of Health, Labour and Welfare: Approved in 2022
- Chinese National Medical Products Administration (NMPA): Approved in 2023
- Taiwan Food and Drug Administration (TFDA): Approved in 2023
- Hong Kong Department of Health: Approved in 2023
- Singapore Health Sciences Authority (HSA): Approved in 2023
Generic Apretude Medicines
Currently, no generic versions are available.
Comparison Table
| Drug Name | Composition | Administration | Target Population | Side Effects | Cost(monthly) | Generic Available |
|---|---|---|---|---|---|---|
| Truvada | Emtricitabine 200 mg + Tenofovir 300 mg | Oral tablet, daily | High-risk populations, including MSM, heterosexuals, etc. | Mild kidney toxicity | $1500–$2000 per month | Yes |
| Descovy | Emtricitabine 200 mg + Tenofovir Alafenamide 25 mg | Oral tablet, daily | High-risk populations with sensitive constitutions | Fewer side effects | $1600–$2200 per month | Yes |
| Apretude | Cabotegravir 600 mg | Injection, bimonthly | High-risk populations who prefer not to take daily pills | Injection site pain | $2000–$3000 per injection | No |
Conclusion
PrEP medications have proven highly effective in preventing HIV infection, but they differ in composition, side effects, target population, and cost. Truvada, as the first approved PrEP drug, offers a cost-effective option through its generic versions and has received widespread international regulatory approval. While Descovy and Apretude offer advantages in terms of side effects and convenience, their higher costs and lack of generic versions limit their accessibility.
When choosing the appropriate PrEP medication, consumers should consider their individual circumstances and financial capabilities. For most people, generic Truvada represents a high-value, effective option.