- Long-acting HIV pre-exposure prophylaxis (PrEP) is now covered by some drug plans in Canada
- Cabotegravir is the first long-acting injectable form of PrEP approved by Health Canada
- This highly effective option is now more accessible in Ontario, Quebec and for Indigenous people
In clinical trials, the drug cabotegravir, given as a long-acting injection ultimately every two months, is highly effective at reducing the risk for HIV infection. This liquid formulation of cabotegravir is injected deep into the buttocks by a healthcare provider. The use of cabotegravir to prevent HIV infection is called pre-exposure prophylaxis (PrEP). Cabotegravir is the first long-acting injectable for HIV prevention to be approved by Health Canada.
After a medicine is approved for use by Health Canada, a long bargaining process gets underway between Canada’s provinces and territories and the drug manufacturer, in this case ViiV Healthcare. In many cases, both sides agree on a price and the drug may then be included on the list of medicines that ministries of health are willing to subsidize. These lists are called formularies.
Price negotiations for long-acting injectable cabotegravir for PrEP (sold under the brand name Apretude) have largely been completed. At publication time it is listed on the formularies of the following:
- Ontario Ministry of Health
- Quebec Ministry of Health and Social Services
- NIHB (Non-Insured Health Benefits Program)
NIHB offers coverage for eligible First Nations and Inuit people who are not provided with subsidized access to medicines through provincial, territorial or private insurance plans. Such coverage from NIHB is important, as about 10% of all people living with HIV in Canada are Indigenous, despite comprising only 5% of the overall population.
Apretude is also listed for coverage by some private insurance plans. It is possible that in the future more places in Canada will provide subsidies for long-acting injectable PrEP. Pharmacists are a helpful source of information about formulary listings.
—Sean R. Hosein
Resources
Health Canada approves Apretude, the first long-acting injectable for HIV prevention – CATIE News
TreatmentUpdate 250 – CATIE
Apretude – CATIE
REFERENCES:
- ViiV Healthcare. ViiV Healthcare announces reimbursement for Apretude for HIV-1 pre-exposure prophylaxis (PrEP) under the Non-Insured Health Benefits (NHIB) Program. Press release. 26 March 2025.
- Blair CS, Cambou MC, Landovitz RJ. Update on HIV chemoprevention. Annual Review of Medicine. 2025 Jan;76(1):43-56.
- Clement ME, Hanscom B, Haines D, et al. Cabotegravir maintains protective efficacy in the setting of bacterial STIs: A secondary analysis of HPTN 083. Clinical Infectious Diseases. 2025; in press.
- Spinelli MA, Bisom-Rapp E, Heise MJ, et al. High retention and adherence with rapid long-acting injectable PrEP implementation in an urban safety-net clinic population. Clinical Infectious Diseases. 2025; in press.