Dr Kevin Astle: Long-Acting Injectables Are a Game Changer for Adherence

Kevin N. Astle, PharmD, BCPS, BCACP, AAHIVP, CDES, assistant professor at the University of South Florida Taneja College of Pharmacy, discusses pre-exposure prophylaxis (PrEP) adherence benefits and potential access barriers for long-acting injectables.

Transcript

With the daily oral pill delivery method being a major barrier to PrEP adherence, how do long-acting injectables help?

The long-acting injectables are really a game changer for adherence, so patients can come to clinic every 2 months and get their injection. We're seeing where we can expand that to pharmacies as well if they have the capabilities so really patients don't have to think about it on a daily basis, they can just get their injection and maintain that adherence. I think it's also great where there's a kind of window for time, so if patients miss their appointment, we can get them rescheduled in the next week or 2 and still see the same efficacy with options.

How do providers determine whether someone is eligible for the injectable therapy?

Now that we have the long-acting injectable approved, getting patients the medication is going to be a big concern. For providers to determine what patients are candidates, it's looking at who has adherence concerns, who will be reliable to get into clinic, so looking at some different social determinants of health. Is transportation a concern? Because if a patient can't get to clinic, that's not going to be a great candidate, whereas with oral options they could potentially get it mailed to them, they can get access to their pharmacy, so looking at that. Cost is a big concern, so for insurance plans [it's] really important for them to cover injectable PrEP at the same co-pay that patients would have for oral tablets to really reduce that barrier. I think that's kind of our biggest area right now.