Long-Acting Injectable PrEP Now Covered By Most Insurance Providers

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We’ve all had those days when the little things, like taking our meds, slip our mind. Sometimes the colourful pill organizers, alarms, and all the notifications just don’t do the trick. That’s why long-acting medications can be especially helpful. 

Last month, Ontario’s public insurance companies and the federal Non-Insured Health Benefits (NIHB) Program added Apretude, a long-acting, injectable PrEP, to their list of covered drugs. While the drug was approved in Canada last year, the out-of-pocket cost is about $2,000 per dose for those without insurance.

WHICH PLANS COVER IT?

• OHIP+ (for folks under 25)
• Ontario Senior’s Drug Program (for folks over 65)
• Ontario Works
• Ontario Disability Support (ODSP)
• Ontario Trillium Drug Program (partial coverage)
• Interim Federal Health (IFH)/Refugee Benefits
• Non-Insured Health Benefits (NIHB)

All of Ontario’s public insurance plans—except the Ontario Trillium Drug Program—provide full coverage of the drug. Payment also varies across private insurance plans with some companies offering full coverage and others requiring a copay.

WHAT IS APRETUDE?

Apretude is the brand name for cabotegravir, the only long-acting injectable pre-exposure prophylaxis (PrEP) treatment approved in Canada. To initiate the treatment, two intramuscular injections are administered to the buttocks one month apart. Afterwards, the injection is administered once every other month.

Apretude has been approved for people who are HIV-negative, over the age of 12, and weigh at least 35 kg (77lbs). 

ORAL PILL VS INJECTABLE

People who are taking cabotegravir see their sexual health provider once every two months to receive the injection and lab work as opposed to the typical three month check-in periods for people taking oral PrEP. Since the treatment isn’t stored in most primary care offices, those taking cabotegravir typically pick up the medication from the pharmacy and bring it to their provider for the injection. Alternative options include receiving the injection at an Alternative Site of Care (ASOC) or a specialized clinic, like the PrEP Clinic (19 Main St.). Sexual health providers and teams are also typically able to provide additional resources to help navigate any financial struggles upon request. 

Clinical trials indicate that this long-acting option is far more effective than oral PrEP. Cabotegravir was found to be 69% more effective at preventing the spread of HIV to HIV-negative men who have sex with men and trans women, and 90% more effective for cisgender women.

SOCIETAL IMPACTS

With greater insurance coverage and far fewer doses, injectable PrEP makes HIV prevention much more accessible for those who can’t or won’t take a daily medication. The most recent HIV data in Canada from 2022 showed a 15% increase in people contracting HIV since 2020, with gay, bisexual and other men who have sex with men (gbMSM), women, and people who use drugs continuing to be the most impacted. As such, Canadian organizations from a variety of sectors are providing a wide offering of testing, prevention, and treatment resources to reduce the virus’ spread.