Nearly 9% of people prescribed PrEP abandoned their prescriptions in 2019
The first study to assess PrEP abandonment at retail pharmacies in the United States found that almost 9% of patients aged 16 years or older failed to pick up their prescriptions in 2019.
“Filling and picking up the PrEP prescription are initial and critical steps of using PrEP to prevent HIV. However, national estimates of the number of people who do not pick up their PrEP prescription were not reported before,” Ya-Lin (Aileen) Huang, PhD, a senior health scientist at the CDC, told Healio.
Huang and colleagues used the IQVIA Real World Data Longitudinal Prescriptions database to estimate the annual number of people who had abandoned their PrEP prescriptions during a 4-year period, and they examined factors associated with abandonment. The study showed that from 2016 to 2019, the annual percentages of people aged 16 years and older who were prescribed PrEP but abandoned their prescription was 8.2%, 8.1%, 7.9% and 8.5%, respectively. Abandonment occurred more often in patients who were newly prescribed PrEP (12.9%) compared with established patients (4.5%); women (13.3%) compared with men (8.1%); patients aged younger than 25 years (11.2%) vs. patients aged 65 years of age or older (14.3%); people who paid with cash (64.5%) or through a drug assistance program (13.2%) vs. other third-party payers; and patients with a copayment exceeding $500 (30.3%) compared with those with a lower copayment.
PrEP abandonment is an important but previously unmonitored event in the PrEP care continuum, and it presents an opportunity for interventions to increase PrEP uptake and support medication adherence,” Huang said. “Clinicians and pharmacists need to be aware of PrEP abandonment and of populations with the highest proportions of abandoned prescriptions.”
The researchers acknowledged that the rates of PrEP abandonment in the study might not capture those who abandoned their prescriptions toward the end of the year but purchased them in early 2020, “resulting in an overestimation of PrEP abandonment.” Also, Black and Hispanic/Latino patients were underrepresented in the IQVIA database, so the researchers “likely underestimated PrEP abandonment in these groups.”
Huang added that moving forward, providers should communicate PrEP costs and copayments to increase patient awareness of cost-sharing requirements to best devise a plan to overcome financial barriers for patients.
“Since January 2021, most health plans were required to offer PrEP to their beneficiaries without copays,” Huang said. “It is important to continue monitoring PrEP abandonment to better understand the impact of the Affordable Care Act provisions to remove financial barriers and increase access to PrEP.”