All the PrEP Hype: Truvada versus Descovy?

Have you heard that there are now two drugs approved for PrEP by the Food and Drug Administration? Truvada has been on the market for about seven years and now Gilead Sciences, the manufacturer of Truvada has gotten approval for Descovy.

Truvada will also be available as a generic as well. Pretty soon the marketplace and options for PrEP will increase. I wanted to take a look at Truvada and Descovy for PrEP and see what the similarities and differences are.

Truvada and Descovy: What's the difference?

Truvada is a combination drug of two medications in one pill. Those medications are tenofovir disoproxil fumarate with emtricitabine (TDF/FTC).1 Descovy is also a combination medication with tenofovir aladenamide with emtricitabine (TAF/FTC).2

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Truvada has been clinically tested with many different populations of people and is been approved for all sexes while Descovy has only been approved for use in men. Descovy has been used in the past as apart of a larger set of HIV therapies and has been approved for HIV positive people for many years. However, it is too soon to really say if one medication is better or safer than the other.

Cost concerns for PrEP

It will be interesting to see this play out in the next couple of years, because as generic PrEP medications become available, Gilead will need to innovate and evolve new formulations that are safer. Now the claim is that Descovy is safer than Truvada; but, the comparison studies haven’t been completed yet.

Moreover, the rush to the assumption that Descovy is better maybe more pushed by the pressure to convert people from Truvada to Descovy, as the cheaper generic versions of Truvada become available to PrEP patients. PrEP is a very expensive medication and can run into the range of $20,000 or more per year of medication. Again, we usually don’t see this high cost with the advent of insurance, and drug assistance programs.

Is there a clinical need to switch PrEP medications?

Julia Marcus, PhD, Assistant Professor in the Department of Population Medicine at Harvard Pilgrim Health Care Institute and Harvard Medical School says, "Gilead is asking us to 'update' our PrEP to TAF/FTC, but that's not a clinically necessary or cost-effective choice for the vast majority of PrEP users."2

Talk to your doctor about your PrEP options

So there is a lot to consider as our options open up for PrEP. More research needs to be conducted and information distributed to health care professionals so that our options can be explained to patients in simple and accurate ways. When choosing medications, it is important to understand for yourself what the medications are doing for your benefit and the potential risk.

Marketing for new drugs should always be looked at critically especially when we have options that work and people are comfortable using. As healthcare professionals and patients navigate these changes, it will only strengthen the relationship by asking more questions about the available options and the possible effects on the body.

Let me know what your reactions are to the news. Have you had experiences with new medications that just didn’t work for your body? Leave a comment below.

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