PrEP Has a New Face and You’re Gonna Sit Right the Fuck on It!

Dr. Evan Goldstein
Aug 20 · 3 min read

“To look life in the face… to know it for what it is...” You all should know where that quote is from, you wolves (hint hint). Life is fucking funny (or is it one big fucking business) and a new PrEP hitting the market seems to be an interesting chess move, specifically as it relates to Gilead and the patent that’s about to expire for their infamous drug Truvada.

If you haven’t heard already, this past week, the FDA gave approval for a new HIV drug known as Descovy®, which is a new addition to the arsenal of preventative HIV medications, a.k.a. PrEP. At first glance, it’s amazing. The more the merrier, right? But while I may not be correct on this — so don’t hold me to it — my second thought was, those fucking greedy pharmaceutical bastards!

Gilead has been under fire for many years because of the exorbitant costs of Truvada, specifically as a preventative approach, and the actual funding of these pivotal trials, which came from grant work provided by — you guessed it — your hard earned taxes. But through legal action by several advocacy groups, this patent was finally struck down and soon enough the generic and much more affordable version will be available to all. Just for a frame of reference: generic PrEP is about $69 a year, whereas in the United States, it can cost up to $1200 a month. Because of this, people will proclaim that now everyone will have access to it, but we know that simply isn’t true. Truvada will remain inaccessible to many, not just because they still cannot afford this miracle medication, but also because it’s not available where they are. It’s just another socioeconomic and geographic barrier that creates a dichotomy in access and care. It’s fucking bullshit.

OK, back to my thoughts. Recently, we (or maybe it’s just me) have seen on TV and in press outlets a lot more ads discussing the negative consequences and side effects on Truvada use. The “have you been prescribed Truvada in the past?” and the “Have you been diagnosed with kidney or liver problems?” and the “You may be entitled to money. Please call blah blah blah!” What’s going on here?! I don’t think it’s just a coincidence… Here’s why:

1. There’s an influx of negative ads

2. The FDA simultaneously approved a supposedly better, more improved drug for PrEP, which has — you guessed it — a patent for the next 20 years

… And all of this is being released a few months before the Truvada patent expires. Jesus Christ. Do you see what I am thinking now!?

There is always going to be a socioeconomic divide when it comes to preventive medicine. For those less fortunate, you can finally take Truvada as PrEP, but we now know it may have some long term consequences. If you can’t afford our new and improved patented version, don’t worry about your kidneys or liver because at least you won’t get HIV. Take that, you ass-eating homosexuals!

Now, this theory of mine may be totally delusional and, who knows, I may delete it later. But it’s what immediately came to mind when I saw the press release and I decided to take a chance and write it down to share it with all of you.

Believe me, I am all for improvements in medications and improvements in side effect profiles and efficacy, but, again, at what cost? And I am all for businesses making money, as long as it’s reasonable and fair. And, boy, this one doesn’t seem like it’s gonna be the new fair deal.

I truly hope I am wrong. But nothing in America right now feels totally normal, now does it? So I leave you with my thoughts and ask you to ponder this discussion so that you can come to your own conclusions. I will say that regardless of the true outcome, we at Bespoke Surgical will continue to be advocates for everyone and I will continue to blog until I can’t blog anymore on what’s truly right — sexual liberties with risk reduction for all.

Don’t forget to stay in touch on Instagram: me and Bespoke Surgical.

Bespoke Surgical

An elite practice purpose-built for today’s male and focused on sexual wellness. Founded by Dr. Evan Goldstein.

Dr. Evan Goldstein

Written by

NY | LA Gay Surgeon discussing ASS: A\rt, S\cience, and S\ex www.bespokesurgical.com/

Bespoke Surgical

An elite practice purpose-built for today’s male and focused on sexual wellness. Founded by Dr. Evan Goldstein.

Welcome to a place where words matter. On Medium, smart voices and original ideas take center stage - with no ads in sight. Watch
Follow all the topics you care about, and we’ll deliver the best stories for you to your homepage and inbox. Explore
Get unlimited access to the best stories on Medium — and support writers while you’re at it. Just $5/month. Upgrade