Infectious Disease

Almost 9% of people prescribed PrEP discontinued their prescriptions in 2019

January 21, 2022

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The authors report no relevant financial information.

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The first study to evaluate PrEP discontinuation in retail pharmacies in the United States found that nearly 9% of patients ages 16 and older did not collect their prescriptions in 2019.

“Filling and collecting the PrEP prescription are first and critical steps in using PrEP to prevent HIV. However, national estimates of the number of people who do not pick up their PrEP prescription have not been previously reported.” Ya-Lin (Aileen) Huang, PhD, one senior health scientist at the CDC, Healio said.

IDN0122Huang_Graphic_01_WEB

Huang and colleagues used the IQVIA Real World Data Longitudinal Prescriptions database to estimate the annual number of people who discontinued their PrEP prescriptions over a 4-year period and they examined factors associated with discontinuation. The study showed that from 2016 to 2019, the annual percentage of people 16 years and older who were prescribed PrEP but discontinued the prescription were 8.2%, 8.1%, 7.9%, and 8.5%, respectively. Discontinuation was more common in patients newly prescribed PrEP (12.9%) compared to established patients (4.5%). women (13.3%) compared to men (8.1%); Patients under 25 years (11.2%) vs. patients 65 years and older (14.3%); People who paid with cash (64.5%) or through a drug assistance program (13.2%) compared to other third-party payers; and patients with a co-payment greater than $500 (30.3%) compared to patients with a lower co-payment.

PrEP discontinuation is an important but previously unmonitored event in the PrEP supply continuum, and it presents an opportunity for interventions to increase PrEP intake and support medication adherence,” said Huang. “Clinicians and pharmacists need to be aware of PrEP discontinuation and the populations with the highest rates of prescription abandonment.”

The researchers acknowledged that the PrEP discontinuation rates in the study may not capture those who abandoned their prescriptions towards the end of the year but bought them in early 2020, “resulting in an overestimation of PrEP discontinuation.” Also, Black and Hispanic/Latino patients were underrepresented in the IQVIA database, so the researchers “probably underestimated PrEP discontinuation in these groups.”

Huang added that going forward, providers should communicate PrEP costs and co-payments to raise patients’ awareness of cost-sharing requirements and develop a plan to overcome financial barriers for patients.

“Since January 2021, most health insurance companies have had to offer PrEP to their beneficiaries without co-payments,” Huang said. “It is important to continue to monitor PrEP withdrawal to better understand the impact of Affordable Care Act provisions to remove financial barriers and improve access to PrEP.”

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