With a monthly dose of PrEP (pre-exposure prophylaxis) in Finland costing 800 euros per month, some Finnish users are ordering the drug from Germany at a fraction of the cost to help keep themselves HIV negative.
Doctors in Finland only prescribe the branded version of the drug, known as Truvada, which is produced by American pharmaceutical company Gilead.
Cost of living
The state has yet to fund the drug, and no official guidelines exist on pre-exposure prophylaxis in Finland. However in many other western European countries PrEP is free or available at a low price. To afford the drug, some people source it from Germany using a cross-border drug prescription, an arrangement within the EU whereby a prescription in one EU state is valid across the bloc.
"That way it costs 50-70 euros per month, depending on the brand," Kirsi Liitsola, an HIV researcher at the National Institute for Health and Welfare (THL) explains.
The high cost is also sending people online to purchase generic versions of the drug with the same active ingredients as its branded counterpart.
Highly effective
"It’s undisputed that PrEP very effectively prevents new infections when taken regularly and coupled with regular blood monitoring," Liitsola says.
To stay protected, those on the antiretroviral regime must take a pill every day, explains Pia Kivelä, an infectious disease specialist at Helsinki University Hospital. She says it has been estimated that regular use of PrEP cuts the risk of becoming infected with HIV by 99 percent. According to the US Centers for Disease Control and Prevention, PrEP has been shown to reduce the risk of HIV infection in people who are at high risk by up to 92 percent, if the medication is taken consistently.
Sami Tuunainen of the Finnish HIV Foundation says PrEP is becoming better known in Finland. But the drug's hefty monthly price tag here —800 euros — is a deterrent.
"A handful of people use it at the moment, but we get a lot of enquiries from bisexual and gay men regarding access to the drug," Tuunainen explains.
Laura Ahonen, chief pharmacist at the Yliopiston Apteekki pharmacy chain, says Finnish pharmacies sell very little Truvada, as most users receive the drug directly from hospitals to manage HIV, not prevent it.
Tuunainen of the HIV Foundation says there’s stigma surrounding the use of prep to prevent HIV.
”If someone says they’re on prep, it means they’re sexually active — something that’s still stigmatised in society,” he claims.