PrEP will soon be available for 50 Euros in Germany, starting in seven cities

"Pills that protect against HIV" will soon be available in generic form in Germany from the manufacturer Hexal in blister packs of 28 tablets – a PrEP for 50 Euros.

This announcement was made by the pharmacist Erik Tenberken on Saturday morning at the general meeting of dagnä, a group of doctors specializing in the field of HIV. This new option is expected to be in place by the end of September.

Tenberken who is a member of DAHKA, a group of pharmacists specializing in HIV and hepatitis, and an honorary member of Aidshilfe Cologne, was able to convince the generic manufacture Hexal to distribute its generic version of Truvada for PrEP use. 

At the beginning of this week, Tenberken expects the promised official approval to be formally granted by the local Cologne government, which would be in keeping with the September timeline.

PrEP for 50 Euros by end-September

In order to get the cheaper PrEP product, patients will first need to consult with a doctor and have a medical examination – after that they will need an individual prescription. The doctor must write something like "28 film tablets emtricitabine / tenofovir disoproxil in a blister pack for PrEP use".

A copy of the prescription must then be sent to Erik Tenberken in Cologne. The pills are then packaged by Kölsche Blister with a special machine and sent to a local cooperating pharmacy by Tenberken. There the customer can pick them up after a short consultation and by handing in the original prescription.

Pharmacies in seven cities are cooperating on this project

Besides the Birken-Apotheke in Cologne (Erik Tenberken), in the first phase of this project, other pharmacies expected to take part are in Düsseldorf (Albert-Schweitzer-Apotheke), Hanover (Leibniz-Apotheke), Hamburg (Alexander-Apotheke), Berlin (Witzleben-Apotheke, Apotheke in der Axel-Springer-Passage), Munich (Marien-Apotheke) and Frankfurt/Main (Eichwald-Apotheke).

Gradually other pharmacies could be added. According to Tenberken, all participating pharmacies will be listed on the website of the Kölsche Blister.

Tenberken pointed out that the low price was not unusual in principle. He got the 50 Euro PrEP through persistent negotiation, and is basically only passing on the discount that he received from the manufacturer. This particular distribution path is open to anyone who wants to try it.

The Deutsche AIDS-Hilfe welcomes this breakthrough but calls for further steps

The Deutsche AIDS-Hilfe welcomes this new development. "We want to make PrEP accessible to all those who need it to protect themselves against HIV," says the DAH's Press Officer Holger Wicht. "This price reduction is a breakthrough. Now, further steps must be taken and others must follow to make PrEP more easily available in other regions."

However, many people at high risk of contracting HIV still cannot afford to pay 650 Euros a year just for tablets. Additionally, the necessary examinations and medical support also cost money. "We need someone to take over these costs, for example health insurance companies – this price reduction now makes it much easier for such solutions," according to the DAH's spokesman.

HIV protection for only 1.82 Euros per pill

The Hexal compound just recently came onto the German market at the end of July with other Truvada generics and is the only one of these drugs approved for both HIV therapy and PrEP use.

For use in HIV therapy or as PrEP it normally costs 1,639.62 Euros for 90 tablets – or 18.22 per tablet. The reduced price for the PrEP-approved pills in a blister pack announced by Tenberken is one-tenth of this sum: 28 tablets cost 51 Euros – or about 1.82 Euros per tablet.

A study shows that PrEP could prevent around 9,000 new HIV infections by 2030

A new study on the cost-effectiveness of HIV pre-exposure prophylaxis in Germany was also presented at the dagnä annual meeting on Saturday.

The study concluded that by implementing PrEP from 2018 onwards, it could prevent about 9,000 new HIV infections by 2030.

This would also be cost-effective for the healthcare system because a lifetime of HIV treatment is more expensive than daily PrEP use. This study went under the assumption that the annual cost of HIV treatment is approximately 17,000 Euros compared to approximately 10,000 Euros a year for a daily PrEP – with the original branded Truvada product.

If the price for the PrEP drug drops by about 40 percent – to around 5,800 Euros per year – daily PrEP use would be even cost-saving.

PrEP for 50 Euros will save money in the end no matter what

The PrEP tablets in blister packaging presented by Tenberken cost only around 650 Euros a year and will reduce costs for the healthcare system in the long run no matter what.

The study was designed by David van de Vijver from the Erasmus University Medical Center Rotterdam in collaboration with the University of Duisburg-Essen, dagnä, and the Robert Koch Institute.

(hs/translated by Timothy Rooks; original news piece: