Challenges and Solutions in Improving PrEP Access in Korea

Recently, with the Korea Agency for Disease Control and Prevention preparing to announce the “Second Prevention and Management Measures of Acquired Immunodeficiency Syndrome (2024~2028)”, the low accessibility of “pre-exposure prophylaxis to ‘HIV (PrEP)’ is becoming a problem in Korea. I am.

It is assumed that many people use PrEP products through direct purchase abroad, clearly revealing the true face of PrEP accessibility.

On February 21, the Korea Disease Control and Prevention Agency held a public hearing to gather opinions from all walks of life on the direction to take in the management of HIV infection. At this event we reviewed the results of the first prevention and control measures of acquired immunodeficiency syndrome implemented in the past 5 years and presented the “2nd basic plan of prevention and control measures of acquired immunodeficiency syndrome (2024-2028)” , which includes political plans for the next 5 years.

Firstly, following the opening of the doors to the first prevention and control measures implemented in the last five years, the overall results compared to the initial objective have been disappointing. Although indicators relating to the treatment rate and viral suppression rate of HIV-infected people have improved, the rate of implementation of other important performance indicators and promotion activities has been insufficient.

As a result, the Korea Disease Control and Prevention Agency announced that it will re-integrate and promote the tasks that were left behind in the first measure and establish a strengthened second measure by adding new tasks. In fact, in the second prevention and control measure, a detailed task of “expansion of PrEP” was specifically created as one of the key tasks to achieve “prevention of new infections”, which is the first promotion strategy.

The aim is to alleviate the cost burden of PrEP drugs, improve accessibility to prescription and strengthen prevention activities for groups vulnerable to infections through promotion.

However, the reality is that doubts are being raised about the government’s will and effectiveness.

The Korea Disease Control and Prevention Agency has set an annual goal of increasing the number of PrEP users by 50 per year, starting with 500 in 2024, to a total of 700 in 2028. However, some believe this target number is insufficient. There are doubts about whether practical prevention can be achieved in a situation where 1,000 new HIV infections occur every year.

The biggest problem is that there is no basis for setting this goal. For effective prevention, estimates of real “high-risk groups” are necessary, but in Korea there are no data on this matter.

Furthermore, the number of PrEP prescriptions in the country is also very low. For example, the number of post-marketing surveillance (PMS) cases for Truvada, the only PrEP drug available in Korea, has been only 22 over the past six years. This is despite the fact that the Korea Medical Assistance Foundation bears 50% of the costs of the drugs.

The problem is that 22 people over the age of 6 does not represent the actual domestic demand for PrEP. The fact that this belies is that there are consumers in Korea who purchase PrEP drugs via direct purchase abroad.

It is estimated that the number of users purchasing generic PrEP drugs online and abroad will far exceed the number of official prescriptions in Korea. Online, in fact, you are informed that you can receive PrEP drugs easily and conveniently by simply entering your card details.

Although PrEP drugs are prescription-only under the Pharmaceutical Affairs Act and it is illegal to sell and buy them online, such direct purchasing sites are thriving.

A national generic PrEP drug purchasing agency is recruiting customers by creating a separate promotional SNS. The number of followers on this SNS reaches 5,674.

This company also often hosts events where it attracts users who retweet promotional posts and give away free generic PrEP medications. The most recent giveaway event post had 170,000 views and 358 retweets.

When purchasing drugs through direct purchase, there are the side effects that can occur if you take drugs without a prescription, the risk of counterfeit drugs being distributed, and even the problem of not knowing how to take them correctly.

There are local PrEP drugs that can be prescribed nationally and there is also a drug cost support project underway, so why do they take all these risks and buy PrEP drugs via direct purchase abroad?

Complex factors are assumed to be at play here, including the complexity of the national PrEP prescribing process and concerns about exposure of personal information due to social bias. This issue is likely to be a major reason for encouraging the direct purchase of PrEP drugs and ultimately constitutes a serious obstacle to HIV prevention efforts in Korea.

Therefore, experts emphasize that there is an urgent need to extend insurance coverage of PrEP drugs to all MSM, simplify the prescription process and, above all, improve social awareness of PrEP.

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