There is only one drug authorised for PrEP in Germany. It is hardly available at the moment. Some pharmacies have remaining stocks, but more and more PrEP users are going without. Patients have also had to switch to other medications for their HIV treatment. A situation that is likely to continue until at least March 2024. This was reported by the Association of Outpatient Physicians for Infectious Diseases and HIV Medicine (dagnä) in a Press Release.
In some cities, PrEP is no longer available at all, as IWWIT has learned from local organisations. In others, such as Berlin, some surgeries are only prescribing monthly packs so that the medication lasts longer - normally one pack lasts for three months. The situation is getting worse by the day.
The reasons for the problem are complex. For example, according to our information, two factories have production problems. There also appear to be individual difficulties in the supply chain and increased demand. Price differences on the European pharmaceutical market are also likely to play a role: Manufacturers in many neighbouring countries apparently receive more money for their medicines than in Germany.
Jonathan Gregory, Head of IWWIT: "It's difficult to say when the situation will ease again. One thing is clear: we have a shortage and not all people who need the medication for PrEP or therapy can be supplied at the moment. There's nothing to gloss over."
Nevertheless, there are still some ways in which PrEP users can obtain their medication. Below are our suggestions for dealing with this difficult situation.
What PrEP users can do now
Contact HIV pharmacies
If your pharmacy no longer has PrEP, contact a pharmacy. Member of the HIV-competent pharmacies working group (DAHKA). These pharmacies exchange information with each other and support each other in supplying PrEP if there are still stocks available. You can also make enquiries via online pharmacies. To do this, ask your doctor for an e-prescription. This makes ordering much easier.
Individual imports from abroad
Pharmacies can try to order the PrEP medication abroad if they obtain prior authorisation from the health insurance company. Some pharmacies do not know this or are afraid of the effort involved. It is best to ask for an "individual import in accordance with Section 73 (3) of the German Medicines Act (AMG)". However, there is no guarantee that the pharmacy will do this and that medication will be available abroad.
Occasion-related PrEP
For some users of daily continuous PrEP, it could also be an option to switch, at least temporarily, to so-called event-related PrEP, where you only take tablets before and after (planned) sex. You can find more information on this at aidshilfe.de/hiv-prep/einnahmeschema.
Approach the practice early for therapy
If you are using the combination of emtricitabine plus tenofovir disoproxil in your HIV treatment, contact your doctor's surgery before your tablets run out so that there is enough time to try to obtain new ones.
Check other safer sex options
If nothing helps, you can consider whether other safer sex options such as condoms or protection through therapy are an option for you until PrEP is available again.
Exchange ideas
It can also be helpful to talk to other PrEP users about their experiences, for example in the Facebook group PreP.Now. Of course you can also register with our Gay Health Chat or with another Offer of the Deutsche Aidshilfe get advice.
We demand security of supply
Deutsche Aidshilfe is campaigning for security of supply for HIV drugs and has called on the Federal Ministry of Health and the Federal Institute for Drugs and Medical Devices (BfArM) to solve the supply problems.
"We won't let up until everyone who needs the medication for PrEP or therapy gets it. You can count on it!" says IWWIT campaign leader Gregory.
