The cost of long-acting ART (antiretroviral therapy) for HIV treatment is an important factor for many individuals considering this option. Long-acting ART, such as Cabenuva, is a new class of treatment designed to reduce the need for daily pills, making it easier to maintain a stable routine. However, these treatments can come with a high price tag. Here’s what to know about the cost, coverage options, and ways to make these treatments more affordable.

1. Understanding Long-Acting ART

Long-acting ART, such as Cabenuva, combines two drugs—cabotegravir and rilpivirine—in an injectable form, which can be administered monthly or every two months. Long-acting ART is a convenient alternative to traditional daily HIV pills and offers benefits like improved adherence and quality of life. However, these benefits often come with higher costs than standard oral ART.

2. How Much Does Long-acting ART Cost?

The cost of long-acting ART depends on various factors, including dosing frequency, insurance coverage, and location. Generally, Cabenuva costs around $3,700 to $4,200 per injection if paying out-of-pocket, with annual costs exceeding $22,000 if administered monthly. This is significantly higher than many daily oral ART medications.

3. Factors Affecting the Cost of Long-acting ART

• Insurance Coverage: Insurance plans often cover long-acting ART but may vary in terms of deductibles, co-pays, and overall coverage. Medicaid and Medicare also cover HIV treatments, but the level of coverage can differ from state to state.
• Co-pay Assistance Programs: Many pharmaceutical companies offer assistance programs to reduce the cost of long-acting ART. ViiV Healthcare, the maker of Cabenuva, has a co-pay assistance program for eligible patients to help lower out-of-pocket costs.
• Government Assistance Programs: Programs like the Ryan White HIV/AIDS Program provide support for HIV treatment, including long-acting ART, particularly for uninsured and underinsured individuals.
• Administration Fees: Long-acting ART requires administration by a healthcare provider, which may include additional costs for office visits.

4. Making Long-acting ART Affordable

• Check for Insurance Coverage: Verify with your insurance provider if long-acting ART is covered and understand any associated costs like co-pays or deductibles.
• Apply for Assistance Programs: Programs from manufacturers and government assistance services can help reduce the cost of treatment.
• Clinical Trials: Participating in clinical trials may offer access to long-acting ART at no cost. Many HIV clinics and medical research centers are actively recruiting for trials on long-acting options, such as Cabenuva and other emerging treatments.

5. Future of Long-acting ART Pricing

As more long-acting HIV treatments become available, prices may become more competitive, and insurance providers may expand coverage. Ongoing research could also lead to longer-lasting injectable or implantable options, potentially reducing the number of doses needed each year and further lowering overall costs.

Final Thoughts

The cost of long-acting ART for HIV is currently high, but many resources are available to help make this advanced treatment accessible. By understanding insurance options, seeking out assistance programs, and considering clinical trials, people living with HIV can explore affordable options for these innovative therapies. Long-acting ART holds promise for a more convenient and consistent approach to managing HIV, making it a worthwhile consideration despite its current cost.