Forty years ago, HIV and AIDS were unheard of in the United States. The first cases of what was then a mysterious illness were diagnosed in the 1980s, but effective treatments took several more decades to develop.
A cure for HIV doesn’t yet exist, but treatments are available to extend the lives of those with HIV and help stop transmission of the virus. Many of the highly active antiretroviral therapies available today work effectively to slow the progression of disease caused by HIV.
But all treatments come with a cost — some more than others. Let’s take a look at the average costs of HIV treatment and potential ways to save money.
Below is a table that contains an average of estimated costs for both brand-name and generic medications. This isn’t a comprehensive list of HIV medications. Talk to a pharmacist to find out the cost of any medication that isn’t included.
These numbers are a snapshot of costs from one day in time, so they’re just a rough estimate. The numbers can give a general idea about drug costs, but keep in mind that there are many factors that can make these medications less expensive. Also new, cheaper drugs come on the market from time to time.
The prices listed don’t take into account any expense covered by health insurance, prescription drug insurance, or government assistance. They’re averages based on information from several websites, including the U.S. Department of Health and Human Services and GoodRx. To find the exact cost for drugs prescribed by a healthcare provider, contact a local pharmacy.
|Drug name (brand name)||Cost of brand name||Cost of generic||Number of tablets or capsules||Strength|
|etravirine (Intelence)||$1,268–$1,414||no generic available||60||200 mg|
|efavirenz (Sustiva)||$1,031–1,047||$273–$389||90||200 mg|
|nevirapine (Viramune)||$857–$922||$15–$38||60||200 mg|
|rilpivirine (Edurant)||$1,040-$1,123||no generic available||30||25 mg|
|lamivudine/zidovudine (Combivir)||$903–$1,005||$78–$334||60||150 mg/300 mg|
|emtricitabine/tenofovir disoproxil fumarate (Truvada)||$1,672–$1,913||no generic available (but one may be available soon)||30||200 mg/300 mg|
|emtricitabine/tenofovir alafenamide (Descovy)||$1,672–$1,783||no generic available||30||200 mg/25 mg|
|abacavir (Ziagen)||$579–$606||$111–$315||60||300 mg|
|emtricitabine (Emtriva)||$539–$599||no generic available||30||200 mg|
|tenofovir alafenamide fumarate (Vemlidy)||$1,064–$1,148||no generic available||30||25 mg|
|tenofovir disoproxil fumarate (Viread)||$1,137–$1,216||$252–$441||30||300 mg|
|fosamprenavir (Lexiva)||$610–$650||$164–$515||30||700 mg|
|ritonavir (Norvir)||$263–$291||no generic available||30||100 mg|
|darunavir (Prezista)||$1,578–$1,697||no generic available||30||800 mg|
|darunavir/cobicistat (Prezcobix)||$1,802–$1,921||no generic available||30||800 mg/150 mg|
|atazanavir (Reyataz)||$1,447–$1,556||$421–$589||30||300 mg|
|atazanavir/cobicistat (Evotaz)||$1,602–$1,708||no generic available||30||300 mg/150 mg|
|raltegravir (Isentress)||$1,498–$1,611||no generic available||60||400 mg|
|dolutegravir (Tivicay)||$1,654–$1,764||no generic available||30||50 mg|
|maraviroc (Selzentry)||$756–$843||no generic available||30||300 mg|
|enfuvirtide (Fuzeon)||$3,558–$3,993||no generic available||60||90 mg|
|abacavir/lamivudine (Epzicom)||$1,286–$1,376||$129–$495||30||600 mg/300 mg|
|abacavir/lamivudine/zidovudine (Trizivir)||$1,651–$1,794||$443–$1,226||60||300 mg/150 mg/300 mg|
|abacavir/dolutegravir/lamivudine (Triumeq)||$2,794–$3,004||no generic available||30||600 mg/50 mg/300 mg|
|efavirenz/tenofovir disoproxil fumarate/emtricitabine (Atripla)||$2,713–$2,893||no generic available||30||600 mg/300 mg/20 mg|
|elvitegravir/cobicistat/tenofovir disoproxil fumarate/emtricitabine (Stribild)||$3,076–$3,281||no generic available||30||150 mg/150 mg/300 mg/200 mg|
|rilpivirine/tenofovir disoproxil fumarate/emtricitabine (Complera)||$2,670–$2,985||no generic available||30||25 mg/300 mg/200 mg|
|elvitegravir/cobicistat/tenofovir alafenamide/emtricitabine (Genvoya)||$2,933–$3,128||no generic available||30||150 mg/150 mg/10 mg/200 mg|
|rilpivirine/tenofovir alafenamide/emtricitabine (Odefsey)||$2,670–$2,847||no generic available||30||25 mg/25 mg/200 mg|
|dolutegravir/rilpivirine (Juluca)||$2,569–$2,739||no generic available||30||50 mg/25 mg|
|bictegravir/emtricitabine/tenofovir alafenamide (Biktarvy)||$2,933–$3,128||no generic available||30||50 mg/200 mg/25 mg|
It’s important to understand that there are many factors that can affect HIV medication costs. Prescription drugs vary in availability, and prices for medications can change quickly. Several other factors can also affect the cost of a medication, including:
- what pharmacy discounts are available
- whether a person has prescription insurance
- the availability of generic versions of medications
- what prescription assistance programs are available
- where a person lives
Some pharmacies and wholesale buyer stores offer loyalty discount programs for customers. These discounts are provided by the pharmacy, not the pharmaceutical company. Shopping pharmacy prices and discount programs can help an individual find one that best suits their needs.
For someone who has insurance, their cost may be lower than the averages listed in the table above. People without insurance may have to pay the cash price for the medication. Cash prices are often higher.
Many HIV medications are new. That means pharmaceutical companies still maintain the rights to the medication’s patent, and as a result, a generic option isn’t available. Generic medications are often less expensive than brand-name drugs.
If a healthcare provider prescribes a brand-name drug, it’s worthwhile to ask if there’s a generic version available instead.
Prescription assistance programs
A variety of prescription assistance programs (PAPs) are available to people taking HIV medications. These programs provide discounts or funds to help cover the cost of HIV treatment. Each PAP maintains its own requirements for participants, such as proof of need for the medication.
An individual can apply for several PAPs, or they can find one that’s specific to their medication. An example is the Ryan White HIV/AIDS Program, which provides significant assistance in obtaining HIV medications.
Out-of-pocket cost for HIV medication and treatments may be dramatically reduced for those who are accepted to a PAP. Many of these programs are operated by the drug manufacturers. A good place to start learning about a PAP is by checking out the website for a particular drug that a healthcare provider is recommending. Or call the drug manufacturer directly.
Medication costs can vary by location. One common reason for this is how Medicaid and Medicare funds are used in the region where a person lives. State governments receive these funds from the federal government, and they can determine how and to whom they allot these funds.
The amount a state reimburses a pharmacy will be higher in states that cover HIV medication costs. As a result, the pharmacy may not charge its customers as much for the medication because they’re getting reimbursed more for them from the government.
A person living with HIV may be able to save a significant amount of money if they understand a few things about cost. These things include how HIV drugs are covered by insurance, and the resources that are available to help manage the often high costs associated with lifelong therapies.
Some insurance companies don’t cover newer HIV treatments. If a healthcare provider prescribes one of these medications to someone whose insurance won’t cover it, that person will have to pay for it out of their own pocket. In this case, finding the best price for their medication may be very important.
For those who don’t have private health insurance or whose insurance company doesn’t currently cover the costs of their HIV medications, there are programs that can help supplement the cost so that these people get the treatments they need.
Following are several strategies for finding assistance in paying for HIV treatment:
- Reach out to the drug manufacturer. Many drug manufacturers have programs to help offset the costs of these life-saving medications. Find contact information by looking at the website of a manufacturer for a particular drug or asking a healthcare provider.
- Contact a state HIV/AIDS hotline. The operators of these hotlines can explain programs and agencies in each state that provide assistance in paying for medications.
- Apply for coverage with Medicaid. Medicaid is a state and federal partnership that provides insurance coverage to low-income individuals, seniors, those with disabilities, and others who qualify. While coverage varies from state to state, Medicaid is an important source of coverage for many individuals living with HIV. To find out more, visit the Medicaid website.
- Seek the services of the Ryan White HIV/AIDS Program. This is a federally funded program that provides services and support for those living with HIV. Its AIDS Drug Assistance Program provides medications to those with limited to no health coverage.
- Look into programs that provide additional services to select groups. These include the Federal Program for Women and Children, the American Indian and Alaska Native Programs, and the Veterans Administration. Each of these organizations offers services to those with HIV.
- Visit drug pricing websites such as GoodRx.com. This site has information on the average costs for medications at several different major pharmacies and offers coupons for further savings. In addition, the site describes how a medication’s cost has averaged over time and how it compares to the cost of other similar medications.
It’s important to remember that cost shouldn’t be the only factor considered when a person pursues medication treatment for HIV. The most important thing is their health.
That said, the reality is that cost is a significant issue. And learning the costs of HIV treatment without financial assistance can be disheartening, especially for those who are newly diagnosed. However, services are available to help people obtain medications, and many of them will cover a large portion of the cost.
With a little work, people with HIV can typically obtain the treatment they need. Following the tips in this article can help. So too can being open with a healthcare provider about whether a medication they prescribe is affordable. The healthcare provider may be able to advise on other ways to save money on medications.