Cohen prepo8/2/2023 ![]() ![]() Truvada is currently one of two medications approved by the US Food and Drug Administration (FDA) for PrEP. PrEP treatment consists of daily use of tenofovir disoproxil fumarate (TDF) and a second medication, emtricitabine (FTC), in combination. An antiretroviral medication, Truvada, is commonly used for pre-exposure prophylaxis (PrEP) and is highly effective in preventing HIV infections. The South accounted for both the highest proportion (51%) and rate (16.8 diagnoses per 100,000 population) of new diagnoses of HIV infection. Of new diagnoses in 2016, nearly 70% occurred among men who have sex with men and were disproportionately concentrated among minorities. Although new HIV diagnoses declined 4.3% from 41,942 in 2012 to 40,534 in 2016, progress has been uneven among different populations and geographic locations in the US and 6 dependent areas. Currently, an estimated 1.1 million individuals are living with HIV. HIV remains a significant public health concern in the United States. Limitations of this study include missing information on prescription claims of patients not included in the database, and for those included, some patients were missing information on patient diagnosis, race/ethnicity, educational attainment, and income (34%–36%). Overall, we estimated the median annual per patient out-of-pocket spending on PrEP was approximately US$72. ![]() Third-party payors covered 95% of the costs of PrEP. Compared to the types of payment methods that people living with diagnosed HIV (PLWH) used to pay for their antiretroviral treatment in 2015 to 2016 reported in the Centers for Disease Control and Prevention (CDC) HIV Surveillance Special Report, PrEP patients were more likely to have used commercial health insurance (80% versus 35%) and less likely to have used public healthcare coverage or a publicly sponsored assistance program to pay for PrEP (12% versus 45% for Medicaid). Of the approximately 24,000 providers who prescribed PrEP, two-thirds reported primary care as their specialty. Compared to individuals with newly diagnosed HIV infection, PrEP patients were more likely to be non-Hispanic white (45% versus 26.2%), older (25% versus 19% at ages 35–44), male (94% versus 81%), and not reside in the South (30% versus 52% reside in the South).Using a ratio of the number of PrEP patients within an MSA to the number of newly diagnosed individuals with HIV infection, we found MSAs with relatively low uptake of PrEP were concentrated in the South. Data were available for 75,839 individuals prescribed PrEP, and findings were extrapolated to approximately 101,000 individuals, which is less than 10% of the 1.1 million adults for whom PrEP was indicated. We analyzed prescription drug claims for individuals prescribed PrEP in the Integrated Dataverse (IDV) from Symphony Health for the period of September 2015 to August 2016 to describe PrEP patients, prescribers, relative uptake, and payment methods in the US. IDV, Integrated Dataverse MSA, metropolitan statistical area PrEP, pre-exposure prophylaxis STROBE, Strengthening the Reporting of Observational Studies in Epidemiology. This files contains the following: a) Table A, IDV prescription patient distribution by census region b) Table B, demographic characteristics of individuals prescribed PrEP with commercial health insurance from September 2015–August 2016 from IDV data and individuals prescribed PrEP with commercial health insurance in 2014 from MarketScan Data c) Table C, summary of chi-squared test results comparing the age, race/ethnicity, and sex composition between PrEP patients and HIV diagnosis d) Table D, number of PrEP patients, number of diagnoses of HIV infection in 2015, and ratio of relative uptake of PrEP by MSA, ranked by ratio from highest to lowest for 107 MSAs e) Table E, number of practitioners prescribing PrEP by specialty, September 2015–August 2016 f) Table F, top 20 diagnoses of PrEP patients g) Table G, top 20 MSAs by number of PrEP-prescribing practitioners, September 2015–August 2016 h) Table H, average patient and third-party payor payments for PrEP by payment method category, September 2015–August 2016. ![]() S1 Appendix: One file of supporting information in addition to the completed STROBE checklist. ![]()
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