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What about safety? In DISCOVER, TDF was linked to small decreases in kidney and bone health, while TAF was linked to small increases in weight gain and cholesterol. The two meds have slightly different side effect profiles. Both are extremely safe. 4/pic.twitter.com/QQI2FLplsO
And finally, there’s cost. TDF and TAF both cost about $24,000/yr in the US, a key reason why PrEP uptake has been slow and inequitable. A generic version of Truvada will be available later this year, which will drive down prices. Generic PrEP could be a game changer. 5/pic.twitter.com/hl6JaV4c06
![Jason Domino [SFW account]](https://pbs.twimg.com/profile_images/1393541302248263682/4WtNbbbi_normal.jpg)
But aggressive marketing of TAF could thwart the benefits of generics. If patients or providers perceive TAF to be "safer" or "more effective" for PrEP, generics could become stigmatized. Fewer people might use PrEP, and disparities in PrEP use could worsen. 6/
More options for PrEP is a good thing. But our choices between options should be informed by clinical evidence and public health context, not hype. Bottom line: for the vast majority of patients, when we think of PrEP, we should still think of TDF/FTC. /end
How much is generic, really? My last refill was generic, and it still cost thousands for a 90-day supply.
Generic TDF/FTC is currently priced only about 15% lower than Truvada and Descovy, but the cost of generics should drop as more formulations hit the market this year.
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