No product, no program: making sure that supplies reach PrEP facilities
A supply chain is a system that moves a product or service from supplier to customer. To establish an oral PrEP supply chain, you should determine the number of pills that will be needed and then procure the pills. Consider if PrEP can be sourced from multiple manufacturers. Multiple sources can bring down costs and ensure reliable supply. The supply chain landscape is dynamic—it’s important to track trends and developments at the global and national levels.
Develop forecasts for PrEP supply and demand
To move ahead with PrEP programs, you need to answer key questions about the supply chain, including how much drug you will need at launch, and over time, based on projected near term demand and expected program growth. Supply chain experts can help answer these questions.
Select the product(s) you will use
Countries need to determine which product they will use for oral PrEP. WHO guidance recommends tenofovir-based PrEP—a category that includes TDF, TDF/FTC and TDF/3TC among currently licensed drugs. There are generic and branded versions of these medications as well. Product selection will inform budgeting, supply chain management and other key steps.
Secure product registration
Each manufacturer must register its PrEP product(s) for use in-country, or governments must provide a waiver for their use. Many of the drugs for oral PrEP are registered for treatment, but some countries require a separate registration or modification specifying an indication for prevention. Click here to see a map of where PrEP has been approved for HIV-prevention.
Procure the product(s) you will be using
Countries will need to procure the correct drugs in the correct quantities, ideally at the lowest possible cost, and select suppliers that ensure timely delivery of quality drugs. A good demand forecast, a fair bidding process and sufficient funding can contribute to successful procurement.
Make a distribution plan for moving product to programs
A distribution plan outlines how to get oral PrEP from central storage facilities to prescribers who will in turn get them to users. Oral PrEP can be distributed together with ARVs where delivery channels already exist, but new delivery systems may need to be established to reach facilities that will only dispense oral PrEP but not ARVs.
This site matches individuals who are interested in PrEP to eligible health plans and provides comparative pricing. PrEPcost.org is designed for both PrEP users and health care providers to make it easy to navigate the insurance options and find the best plans available.
At least 309,525 people have started to take PrEP in 68 countries, but 71 percent of PrEP users are in North America, according to a global analysis presented by AVAC to the HIVR4P conference in Madrid.
The OPTIONS Consortium has created a new five-part video series, Demand Creation for PrEP, focused on demand creation for HIV prevention behaviors drawn from the OPTIONS led 2018 AIDS Pre-Conference event, Insight to Impact.