Switzerland is currently grappling with a significant shortage of the sole generic drug prescribed and reimbursed for HIV PrEP, presenting a serious challenge to public health. This issue not only affects the pharmaceutical domain but also poses a broader public health concern. In these turbulent times, sharing information, offering mutual support, and adapting prevention strategies are crucial. This shortage is a part of the global LGBTQIA+ context, where community health concerns are gaining worldwide attention.
Delivery Disruption Announced by Mepha
Mepha, a Swiss laboratory, has announced a nationwide supply interruption for its Emtricitabin-Tenofovir. Currently, this is the only generic medication approved and covered for HIV pre-exposure prophylaxis (PrEP) under Switzerland’s mandatory health insurance.
Information shared with prevention agencies and health professionals indicates that deliveries to pharmacies, hospitals, and medical offices may cease as early as March, with no assured resumption before summer.
Practically, this means many may find it difficult to access their preventive medication in the upcoming weeks.
A Crucial Tool in HIV Prevention
This situation is substantial because HIV PrEP is one of the most effective measures to prevent viral transmission. A prolonged disruption could significantly undermine the prevention strategies developed in recent years.
Particularly affected could be the highest-risk populations, including men who have sex with men and certain trans individuals. A continuing shortage poses a genuine risk of increased infection rates.
PrEP in Switzerland: Recent Developments and Vulnerabilities
Since July 1, 2024, the inclusion of PrEP under mandatory health insurance, following OPAS (art. 12b let. i), marked a significant step forward in HIV prevention in Switzerland. Both the treatment and its medical follow-up are now eligible for reimbursement under conditions outlined by the Federal Office of Public Health (OFSP).
According to data from the SwissPrEPared program, over the past year, more than 7,000 people have had at least one consultation within this framework.
However, the Swiss model exhibits a structural weakness: only one generic drug has the necessary indication for LAMal reimbursement, thus access to PrEP relies heavily on a single supplier.
This reliance underscores the fragility of a system critical to public health and the communities involved.
Maintaining an Effective Protection Strategy
In this scenario, one key principle remains: anyone engaging in sexual activities outside an exclusive relationship should maintain an effective HIV prevention strategy.
While PrEP is an incredibly efficient tool, it isn’t the only option nor a fixed one. Temporarily altering habits can help maintain both individual and community protection.
Practical Tips for Individuals on PrEP
1. Adjust Usage Patterns
According to Swiss guidelines, a “demand-driven” approach is feasible, limiting intake to times of planned or likely sexual activity (for instance, a sauna visit, a meeting arranged via an app, or a night out at a bar or club).
To maintain effectiveness:
– Take two tablets between 2 and 24 hours before the initial sexual encounter;
– Continue with one tablet daily as long as sexual activity continues;
– Maintain a daily tablet regimen for at least two days post-last encounter for cisgender men, and at least seven days for other individuals.
If there’s no sexual activity during the last two (cisgender men) or seven days (other individuals), pausing PrEP intake is feasible. These pauses help conserve tablets while ensuring protection. If new sexual activity is foreseen, resume with two tablets beforehand.
For unexpected encounters without prior PrEP intake, non-penetrative practices remain possible. For penetrative activities, using a condom provides a highly effective alternative, provided it’s available.
2. Sourcing Medication from Abroad
Swiss legislation permits importing medicines for personal use, limited to a single box per month.
Individuals residing near a border can typically acquire treatments from foreign pharmacies with a Swiss prescription. However, insurance might refuse or limit reimbursement if the foreign medication is more costly compared to Switzerland — a common occurrence.
Exercise caution when ordering from abroad:
– Use reliable websites based on recommendations from community or prevention organizations;
– Ensure the medication contains both Emtricitabine (FTC) and Tenofovir (TDF or TAF);
– Be prepared for delivery delays.
Even if some platforms offer sales without a prescription, medical oversight remains crucial: check for contraindications, monitor bodily effects, ensure hepatitis B immunity, and undergo regular HIV and syphilis screenings.
Solidarity as a Collective Response
Facing the shortage, community solidarity is crucial. Individual actions have collective consequences.
Simple measures can mitigate the impact:
– Only take one box at a time to preserve supplies;
– Support those who are temporarily without treatment.
Hoarding unused stock offers no extra protection but can deprive someone else of critical prevention tools. Taking care of oneself also means looking out for others.
A Shortage Highlighting a Larger Issue
Supply disruptions aren’t exclusive to PrEP. Drug shortages are increasingly common in Switzerland, a country central to the global pharmaceutical industry.
The reliance on a single PrEP product highlights a clear structural vulnerability. Globally, several alternatives exist: various oral options and long-acting injectables are under development.
Injectable preventive treatments every two months (Cabotegravir LA) or every six months (Sunlenca) have received recommendations from bodies like the World Health Organization (WHO), the European AIDS Clinical Society (EACS), and the Centers for Disease Control and Prevention (CDC).
Cabotegravir LA has received approval from international regulatory bodies like the European Medicines Agency (EMA) and is increasingly being integrated into national policies, notably in the United States, Canada, United Kingdom, and France since February 26, 2026.
Turning Concern into Action
This crisis underscores that advances in community health aren’t entirely secure.
PrEP has notably decreased HIV transmissions in many nations, including Switzerland, particularly among gay, bisexual, and other men who have sex with men.
In the current scenario, several measures are necessary:
– Temporarily adapt personal practices;
– Bolster community solidarity;
– Advocate politically to ensure future treatment availability and diversify the options authorized and reimbursed in Switzerland.
Preserving personal health also protects others. Sustaining informed and supportive community prevention is more vital than ever.
For ongoing updates, follow @DrGay_fr on social media (Instagram, Facebook) and subscribe to the SwissPrEPared newsletter.
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