Following the results of a Phase IIb/III trial that showed GSK’s investigational HIV prevention drug cabotegravir had superior efficacy over Gilead’s Truvada;

Arafa Salam, PhD, Infectious Diseases Analyst at GlobalData, a leading data and analytics, company offers her view:

“Although cabotegravir may be more effective than Truvada, cabotegravir has potential high costs. Moreover, there are potential issues for most HIV-risk individuals when administering an injection of this drug.

“GSK’s Phase IIb/III (HPTN 083) trial showed that cabotegravir, a drug used for pre-exposure prophylaxis (PrEP) had superior efficacy over the currently reigning PrEP, Truvada. The trial identified that there were only 0.41% HIV incident cases in the cabotegravir arm, in comparison to 1.22% in the Truvada arm, a decrease of 66%. Due to the superior efficacy of cabotegravir, the trial was stopped early after a review was conducted by an independent data monitoring panel.

“Cabotegravir is an injectable given every two months in the physician’s clinic, while Truvada is an oral tablet administered daily; key opinion leaders (KOLs) interviewed by GlobalData have concerns over individuals wanting to go into clinics to get a long and painful injection, therefore adherence may be an issue. Whereas, with an oral tablet, the individual can take it from the comfort of their own home without any painful site reactions.

“In addition, Truvada costs $1,780 for a 30-day dosing regimen in the US, whilst in other parts of the world generic versions are available for approximately $40 for a 30-day supply. In the US, the generic version of Truvada will be available as of September 2020 where it may cost $40. Therefore, due to the lower price, individuals may prefer to continue taking Truvada over the expensive injectable cabotegravir, as insurance policies may not reimburse the injection or it may not be funded through charitable organizations such as the Ryan White HIV/AIDS program.

“Therefore, although superior effects of cabotegravir were identified over Truvada, patients may still prefer Truvada due to the ease of administration as well as the likely lower cost.”