The drug PrEP is nearly 100% effective at stopping HIV but can cost $1,000/month. Now Alberta may fund it

After years of urging the province for changes, sexual health advocates are hopeful Alberta will finally fund an expensive drug that can prevent the spread of HIV.

Move could reduce costs of drug that is too expensive for many

Pre-exposure prophylaxis (PrEP) is a groundbreaking treatment that protects against HIV, but it can cost up to $1,000 per month. (CBC)

After years of urging the province for changes, sexual health advocates are hopeful Alberta will finally fund an expensive drug that can prevent the spread of HIV.

The province is looking at adding pre-exposure prophylaxis, or PrEP, to its public drug plan, which would make the prescription more widely available and perhaps far cheaper.

"I think I speak for any gay man or any man who has sex with men when I say there is that underlying anxiety when it comes to HIV," said Kyle Wilson, a 25-year-old Calgarian who can't afford to buy the drug.

"We have so many tools available to prevent the spread of HIV, and it's quite infuriating to see that we're not taking advantage of them to the full extent that we can."

When taken as prescribed, the once-daily pill is up to 99 per cent effective at preventing the spread of HIV, a disease that has hit about 6,800 Albertans, according to advocates. Last year alone, there were more than 200 diagnoses.

The brand name version of the medication, Truvada, can cost up to $1,000 per month, which is unaffordable for many.

Ontario and Quebec subsidize the drug in their public plans, while the medication is now free in British Columbia for anyone at high risk of getting HIV.

In Alberta, even generic versions can cost $400 to $500 per month without private insurance.

When taken as prescribed, the once-daily pill is up to 99 per cent effective at preventing the spread of HIV. (CBC)

"Although PrEP is not an HIV vaccine, it works like a vaccine," said Alex Smith, a Calgary nurse who has developed a method for patients to import the drug from foreign suppliers for just $45 monthly.

"People who take it have a high, high degree of protection. I think if an HIV vaccine were available, the province would be falling over itself to provide that type of prevention."

Hundreds of Canadians use Smith's method — outlined on his website, the Davie Buyers Club — which involves importing the medication from suppliers in India, Thailand and Singapore.

They order a 90-day supply. That's the maximum legal quantity of medication to import into Canada for personal use. It's shipped to a U.S. mailbox that they have pre-registered for. Then, they cross the border and personally pick up the package.

A graphic from the Davie Buyers Club illustrates the process of ordering generic PrEP online. (Davie Buyers Club)

Despite his website's success, with 20,000 page views, Smith wants his import method to become obsolete. He'd rather see provinces covering PrEP in their drug plans.

"I know people who drive for three hours to get this medication at the U.S. border," said Smith, who works in harm reduction and sexual health. "I don't think that it's right for Canadians to have to go to another country to receive their medical treatment."

The Alberta government said in a statement it is conducting a months-long review of generic PrEP to assess possible coverage, looking at the potential costs to patients and government, practices in other jurisdictions, potential ranges of coverage and overall accessibility.

Leslie Hill, executive director of HIV Community Link, says the Alberta government's review presents a "significant opportunity to turn the tide" on HIV. (CBC)

"Truvada is not intended to replace other safe sex practices because it is not 100 per cent effective, is substantially less effective if used inconsistently or incorrectly, and will not protect against other sexually transmitted infections such as syphilis or gonorrhea," the government said.

Leslie Hill, the executive director of HIV Community Link, said the review presents a "significant opportunity to turn the tide" on HIV.

"If there is publicly funded access for those at increased risk of transmission," Hill said, "we think it creates a tipping point and has huge potential to impact the HIV epidemic."

The Ontario government will start paying for a drug that can protect sexually active people from HIV infection 1:56

About the Author

Reid Southwick

Reporter

Reid Southwick spent 10 years in newspapers reporting in New Brunswick and Alberta before joining CBC in late 2017. In Calgary, he has covered business news, crime and Alberta's fentanyl crisis. Get in touch with Reid by email at reid.southwick@cbc.ca or on Twitter @ReidSouthwick.