How to Help Your Patients Find Apretude in Stock: A Provider's Guide

More patients are asking about Apretude — the every-two-months injectable PrEP option that's proven superior to daily oral Truvada in clinical trials. But offering injectable PrEP requires more than just a prescription pad. This guide walks through what providers need to do to actually deliver Apretude to their patients.

Why Injectable PrEP Is Worth Setting Up in Your Practice

Apretude's clinical efficacy is extraordinary: it demonstrated 69% fewer HIV infections in cisgender men and transgender women compared to daily oral Truvada (HPTN 083), and 90% fewer HIV infections in cisgender women (HPTN 084). Over 3 years of real-world experience with more than 5,000 patient-years of clinical trial data backs these results.

Beyond efficacy, injectable PrEP removes the daily adherence burden that causes many patients to discontinue or inconsistently use oral PrEP. For patients who struggle with daily pill-taking, or who prefer privacy in their HIV prevention, Apretude is a clinically meaningful option.

Step 1: Establish a Specialty Pharmacy Relationship

Apretude does not flow through traditional drug wholesalers. To administer it, your practice needs to establish a relationship with a specialty pharmacy that handles ViiV products. ViiVConnect (ViiV Healthcare's patient support hub) can facilitate this — they work with TheraCom, a specialty pharmacy that handles Apretude distribution. Once approved, Apretude will be shipped directly to your practice.

Enroll your practice through ViiVConnect by calling 1-877-844-8872. The enrollment process includes practice verification, payer coverage review, and setting up specialty pharmacy logistics.

Step 2: Understand Your Billing Options

Apretude can be billed under two models:

Buy-and-bill (medical benefit): Your practice purchases the drug from the specialty pharmacy and bills the payer using the appropriate J-code. This model is common for clinic-administered medications.

Specialty pharmacy billing (pharmacy benefit): The specialty pharmacy ships Apretude to your office and bills the payer directly under the pharmacy benefit. Your practice bills separately for the injection administration and clinical visit.

Your payer mix will influence which model works better. Consult with your billing department and with ViiVConnect's reimbursement support team. ACA mandates $0 cost-sharing for Apretude and related PrEP services (testing, counseling, office visit) under most plans.

Step 3: Build Your Pre-Injection Protocol

Every Apretude administration requires the following protocol, per FDA prescribing information:

HIV-1 test: Using an FDA-approved test for acute/primary HIV. Antigen/antibody tests must be confirmed with HIV RNA. Consider point-of-care testing to reduce delays.

Medication review: Check for contraindicated UGT1A1/1A9 inducers (rifampin, rifapentine, carbamazepine, oxcarbazepine, phenobarbital, phenytoin, apalutamide).

Symptom assessment: Screen for depressive symptoms and hepatic disease signs.

Injection technique: Apretude is administered as a 600 mg (3 mL) gluteal IM injection ONLY. Shake vial vigorously before drawing. Administer within 2 hours of drawing into syringe.

Injection scheduling: Doses are every 2 months after the two 1-month-apart initiation injections. A 7-day window is allowed before or after the target injection date.

Step 4: Set Up Patient Tracking and Recall Systems

Because Apretude is given every two months, and because missed doses have serious clinical implications (potential drug-resistant HIV in the pharmacokinetic tail), practices need robust patient recall systems. Consider:

Scheduling follow-up appointments at each visit for the next injection (2 months out)

Automated appointment reminders (phone, text, email) sent 1 week before each injection date

Proactive outreach to patients who are overdue (beyond 7 days past target date)

Oral cabotegravir bridge protocol for patients who will miss a dose by more than 7 days

Step 5: Know Your Patient Financial Resources

Many patients will have $0 cost-sharing under their ACA plans or Medicare. For those who need financial assistance:

ViiVConnect Savings Program: commercially insured patients may pay $0 (enroll at ViiVConnect.com)

ViiV Patient Assistance Program: uninsured patients with limited income may receive at no charge (1-844-588-3288); grants up to $5,000/year available through some programs

State AIDS Drug Assistance Programs (ADAPs): cover Apretude in many states

When to Refer Rather Than Administer

If your practice isn't ready to offer injectable PrEP yet, consider referring to an HIV specialty clinic, Ryan White-funded health center, or ID specialist who is. A warm handoff is better than leaving patients without access to the option they want.

medfinder for Providers at medfinder.com/providers offers tools to help your practice support medication access for all your patients — including those looking for injectable PrEP.