The purpose of this memo is to announce the release of the Pre-Exposure Prophylaxis (PrEP) Assistance Program (PrEP-AP) Generic PrEP Policy. A generic version of the human immunodeficiency virus (HIV) PrEP combination medication tenofovir disoproxil fumarate/emtricitabine became available on October 2, 2020. Generic tenofovir disoproxil fumarate/emtricitabine was added to the PrEP-AP Formulary January 4, 2021. The PrEP-AP Generic PrEP Policy outlines changes to PrEP-AP due to the introduction of the first generic version of an HIV PrEP medication and explains the changes to covered medications by PrEP-AP client type. The PrEP-AP Generic PrEP Policy Flowchart provides a graphic representation of the information detailed in the PrEP-AP Generic PrEP Policy. 

The generic version of PrEP manufactured by Teva Pharmaceuticals, which has also established a generic PrEP Savings Card to be used towards the cost of the copays for insured individuals who qualify for their program. PrEP-AP clients with health insurance who are prescribed generic PrEP will be required to use the Teva savings card. The Savings Card can be downloaded from the Teva (drug manufacturer) webpage.

Clients will receive PrEP-AP Benefits as described below:

Insured Clients

As outlined in Management Memorandum 2020-20: PrEP-AP Eligibility Requirement Change for Insured PrEP-AP Clients, PrEP-AP changed its policy and does not require clients to enroll into Gilead’s Copayment Assistance Program as the client’s health plan may cover the cost of PrEP effective June 11, 2020, unless the health plan has yet to implement U.S. Preventative Services Task Force (USPSTF) recommendation.

If a client’s health plan has yet to implement the USPSTF recommendation for health plans to cover PrEP as a preventative service, the client will be required to apply to the Gilead Co-pay Assistance Program, to cover the cost of the co-pay if they are prescribed brand name Truvada® (or Descovy®). If the client’s health plan has yet to implement the USPSTF recommendation, and they are prescribed generic PrEP, they will be required to apply to the Teva Generic PrEP Savings Card.

Uninsured Clients

Uninsured PrEP-AP clients should be prescribed brand name Truvada® (or Descovy®), and will continue to be required to apply for medication assistance through Gilead’s Patient Assistance Program.

Minor Clients & Clients with Confidentiality Concerns

PrEP-AP covers the full cost of medications and services for clients who are enrolled in PrEP-AP as uninsured because they are 1) minors, or 2) have confidentiality concerns using their own health insurance through a parent, spouse, or domestic partner. To ensure coverage by PrEP-AP, Clinical Network providers should prescribe generic PrEP. If Descovy® is clinically indicated for the client, the clinician can write the prescription as a Dispense as Written (DAW) to allow an override of the generic medication requirement.

Medicare Clients

PrEP-AP will cover the cost of PrEP medication copays for clients with Medicare Part D drug coverage. Medicare clients without Part D drug coverage should be prescribed brand name Truvada® (or Descovy®), and will continue to be required to apply for medication assistance through Gilead’s Patient Assistance Program.

PrEP-AP requests that you share this information with your clinical leadership team and local prescribers. The PrEP-AP drug formulary has been updated to reflect the addition of generic tenofovir disoproxil fumarate/emtricitabine. The updated formulary can be found here: Updated PrEP-AP Formulary.

If you have any questions regarding the PrEP-AP Generic Policy, please contact PrEP-AP Support, at prep.support@cdph.ca.gov.

Thank you,