Dr Fiona Bisshop writes that despite the disruption to the PrEP supply in Australia, users should not panic. Instead, she says, be PrEPared!
PrEP is a once-daily pill for pre-exposure prophylaxis for HIV. The combination of tenofovir and emtricitabine provides a reliable way to avoid contracting HIV. We generally tend to call it PrEP to avoid having to master those tongue-twisters. The government subsidises generic versions of the original PrEP pills through the Pharmaceutical Benefits Scheme (PBS). However, they removed Truvada itself from the PBS in April 2020.
Prior to the 2018 listing of PrEP on the PBS, cost prohibited access for many. Online overseas pharmacies provided the cheapest option and still remain cheaper than buying PrEP at Australian chemists. (Unless you possess a low-income healthcare or pension card.)
Reports suggest some users recently experienced difficulty obtaining PrEP at their local pharmacies. Doc Q discussed the shortage with a number of pharmacists. It seems a product recall by the largest generic manufacturer caused a national shortage of the medication.
Some other medications are also in short supply. One of the most commonly prescribed antidepressants in Australia, sertraline, has also been difficult to get recently.
These shortages are due to supply chain issues. Australia does not manufacture a lot of pharmaceuticals. Therefore, they have to be imported. From time to time, disruptions occur to the supply chain, e.g. a product recall or a factory fire in India. You might be forgiven for thinking that the pandemic caused the shortages. In fact, there were no more shortages in 2020 than in previous years, despite some difficulties due to border closures.
Places you can still source PrEP
If you are having trouble finding PrEP, you might have more luck at an inner-city pharmacy. They tend to keep more on the shelves (I spoke with a local pharmacist in Fortitude Valley who has plenty). Or use your script to order from an online pharmacy. (Of course, delivery will take some weeks.) The PrEP Access Now website contains information on online ordering – www.pan.org.au
Please remember that when you stop taking PrEP, your protection against HIV ends. Anyone possibly exposed to HIV after stopping PrEP, can access PEP (post-exposure prophylaxis) at sexual health clinics, hospital emergency departments and certain LGBTQ GP practices.
My final piece of advice is to be a good boy (or girl) scout!
Don’t wait until your pills run out to get your script renewed or refilled. Phone your pharmacy and check the situation ahead of time.
If you can’t get hold of any, then keep your (or your partner’s) rocket in your pocket until you can, or wrap it up in latex in the meantime!
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