The Cost of HIV Treatment
The cost of drugs for HIV can be high. You can save money by using generic or name brand drugs, using prescription insurance, or participating in an assistance program.
Forty years ago, both HIV and AIDS were unheard of in the United States. The first cases of what was then a mysterious illness were diagnosed in the 1980s, but effective treatments took several more decades to develop.
A cure for HIV does not yet exist, but treatments are available to extend the lives of those with HIV and help prevent the transmission of the virus. Many of the highly active antiretroviral therapies currently available work effectively to help slow disease progression caused by HIV.
Treatments have costs that are higher than others.
The average costs of HIV treatment are high, so we should look at ways to save money.
“The table below shows the average estimated costs for brand-name and generic drugs. This is not a complete list of HIV drugs. You can talk to a pharmacy about the cost of medication that isn’t included.”
These are a snapshot of costs from one day in time.
They can give a general idea of the cost of drugs, but keep in mind that there are many factors that can make the drugs less expensive.
New drugs are usually expensive when they reach the market. Older drugs may be more affordable.
The prices listed do not take into account the cost of health insurance, prescription drug insurance, or government assistance.
They’re averages based on information from several websites, including the U.S. Department of Health and Human Services and GoodRx.
The exact cost of drugs prescribed by your healthcare team can be found by contacting a local pharmacy.
| Drug name (brand name) | Cost of brand name | Generic available | Number of tablets or capsules | Strength |
|---|---|---|---|---|
| etravirine (Intelence) | $1,477 | yes | 60 | 200 mg |
| efavirenz (Sustiva) | $94 | yes | 90 | 200 mg |
| nevirapine (Viramune) | $30 | yes | 60 | 200 mg |
| rilpivirine (Edurant) | $1,320 | no | 30 | 25 mg |
| lamivudine/zidovudine (Combivir) | $810 | yes | 60 | 150 mg/300 mg |
| emtricitabine/tenofovir disoproxil fumarate (Truvada) | $266 | yes | 30 | 200 mg/300 mg |
| emtricitabine/tenofovir alafenamide (Descovy) | $2,530 | no | 30 | 200 mg/25 mg |
| abacavir (Ziagen) | $605 | yes | 60 | 300 mg |
| emtricitabine (Emtriva) | $560 | yes | 30 | 200 mg |
| tenofovir alafenamide fumarate (Vemlidy) | $1269 | no | 30 | 25 mg |
| tenofovir disoproxil fumarate (Viread) | $696 | yes | 30 | 300 mg |
| fosamprenavir (Lexiva) | $1,268 | yes | 60 | 700 mg |
| ritonavir (Norvir) | $228 | yes | 30 | 800 mg |
| darunavir ethanolate (Prezista) | $2,501 | yes | 30 | 800 mg |
| darunavir/cobicistat (Prezcobix) | $2,798 | no | 30 | 800 mg/150 mg |
| atazanavir (Reyataz) | $1,556 | yes | 30 | 300 mg |
| atazanavir/cobicistat (Evotaz) | $1,912 | no | 30 | 300 mg/150 mg |
| raltegravir (Isentress) | $2,355 | no | 60 | 400 mg |
| dolutegravir (Tivicay) | $2,458 | no | 30 | 50 mg |
| maraviroc (Selzentry) | $1,686 | yes | 60 | 300 mg |
| enfuvirtide (Fuzeon) | $3,568-$3,729 | no | 60 vials | 90 mg |
| abacavir/lamivudine (Epzicom) | $1,225 | yes | 30 | 600 mg/300 mg |
| abacavir/lamivudine/zidovudine (Trizivir) | $1,520 | yes | 60 | 300 mg/150 mg/300 mg |
| abacavir/dolutegravir/lamivudine (Triumeq) | $4,207 | no | 30 | 600 mg/50 mg/300 mg |
| efavirenz/tenofovir disoproxil fumarate/emtricitabine (Atripla) | $2,450 | yes | 30 | 600 mg/300 mg/20 mg |
| elvitegravir/cobicistat/tenofovir disoproxil fumarate/emtricitabine (Stribild) | $4,607 | no | 30 | 150 mg/150 mg/300 mg/200 mg |
| rilpivirine/tenofovir disoproxil fumarate/emtricitabine (Complera) | $3,912 | no | 30 | 25 mg/300 mg/200 mg |
| elvitegravir/cobicistat/tenofovir alafenamide/emtricitabine (Genvoya) | $4,593 | no | 30 | 150 mg/150 mg/10 mg/200 mg |
| rilpivirine/tenofovir alafenamide/emtricitabine (Odefsey) | $3,178 | no | 30 | 25 mg/25 mg/200 mg |
| dolutegravir/rilpivirine (Juluca) | $3,922 | no | 30 | 50 mg/25 mg |
| bictegravir/emtricitabine/tenofovir alafenamide (Biktarvy) | $4,428 | no | 30 | 50 mg/200 mg/25 mg |
There are many factors that can affect the cost of HIV medication. Prices of medications can change quickly. The cost of a medication can be affected by a number of other factors.
- What pharmacy discounts are available?
- Is a person covered by prescription drug insurance?
- Generic versions of medications are available.
- What programs are available?
- Where a person lives.
Pharmacy discounts
Some stores offer loyalty programs. The pharmacy gives these discounts. A person can find a pharmacy that suits their needs by shopping for prices and discount programs.
Prescription insurance
The table above shows the average cost for someone who has insurance. The cash price for the medication may be paid by people without insurance. Cash prices are higher.
Generic drugs
There are many new HIV medications. The patent on the medication is still held by the pharmaceutical companies, so a generic option is not available. Generic drugs are often cheaper than brand-name drugs.
If a healthcare professional prescribes a brand-name drug, it may be worthwhile to ask if there is a generic version available.
Prescription assistance programs
People taking HIV medications can get assistance with their prescriptions. The programs give discounts or funds to help pay for HIV treatment. PAPs have their own requirements for participants, such as proof of need for the medication.
An individual can apply for several PAPs, or they can find one that’s specific to their medication. An example is the Ryan White HIV/AIDS Program, which provides significant assistance in obtaining HIV medications.
Those who are accepted to a PAP may be able to save a lot on out-of-pocket costs for HIV medication. Drug manufacturers operate many of these programs.
A good place to start learning about a PAP is by checking out the website for a particular drug that a healthcare professional is suggesting or calling the drug manufacturer directly.
Location
Medication costs can vary by location. One common reason for this is how Medicaid and Medicare funds are used in the region Where a person lives.. State governments receive these funds from the federal government, and they can determine how and to whom they administer these funds.
“States that cover HIV medication costs will reimburse a pharmacy more than states that don’t. The pharmacy may not charge customers more for the medication because of a higher government reimbursement rate.”
A person with HIV may be able to save money on their medication. Taking advantage of certain resources can help reduce HIV medication costs.
Some insurance companies do not cover newer HIV treatments. If a healthcare professional prescribes a medication to someone who does not have insurance, the person will have to pay for it themselves. Finding the best price for their medication may be important.
Some programs may be able to help those who do not have private health insurance or who have an insurance company that does not cover HIV medications.
There are several ways to find assistance in paying for HIV treatment.
Reach out to the drug manufacturer
Drug manufacturers have programs to help cover the costs of their drugs. You can find contact information for a drug manufacturer by looking at their website.
Use a hotline
Contact a state HIV hotline. Hotline operators can explain programs and agencies in each state that provide assistance with paying for medications.
Apply for coverage with Medicaid
Medicaid is a state and federal partnership that provides insurance coverage to low income households, older adults, those with disabilities, and others who qualify. While coverage varies from state to state, Medicaid is an important source of coverage for many individuals living with HIV. To find out more, visit the Medicaid website.
Contact Ryan White HIV/AIDS Program
The Ryan White HIV/AIDS Program is a federally funded program that provides services and support for those living with HIV. Its AIDS Drug Assistance Program provides medications to those with limited or no health insurance coverage.
Search for other programs
Look into programs that provide additional services to select groups. These include the Children’s Health Insurance Program, the American Indian and Alaska Native Programs, and the Department of Veterans Affairs. Each of these organizations offers services to those with HIV.
Visit drug pricing websites
Drug pricing websites such as GoodRx.com have information on the average costs for medications at several different major pharmacies and offer coupons for further savings. In addition, the sites describe how a medication’s cost has averaged over time and how it compares to the cost of other similar medications.
It is important to remember that cost is not the only factor considered when a person is considering medication for HIV. Their health is the most important thing.
The reality is that cost is a significant issue. It can be hard to learn about HIV treatment costs without financial assistance. Many of the services available will cover a large portion of the cost of the medication.
People with HIV can usually get the treatment they need with a little work. The tips in this article may help.
It is possible to help a practice by being open with a healthcare professional about whether a medication is affordable. The healthcare professional can advise on ways to save money on drugs.
