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Truvada vs Generic PrEP vs DESCOVY

Truvada vs Generic PrEP vs DESCOVY

Updated on:
November 9, 2021

In Canada, there are three different forms of PrEP as medicine; Truvada PrEP, a generic PrEP, and Descovy PrEP. The existence of multiple pills that all eliminate the risk of contracting HIV (by 99%) can make the decision harder for users. So what is the difference between these three offerings?

Truvada for PrEP

Truvada is simply a brand name for Gilead Health. Truvada contains two anti-HIV drugs; tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC). It is a small pill taken daily (or as PrEP on demand). Daily use has shown a 99% effectiveness for PrEP in eliminating the risk of contracting HIV.

While the frequency in which side effects occur is very low in users, the TDF ingredient in Truvada can affect bone and kidney health. As a result, individuals who have pre-existing bone and kidney health conditions are not recommended to use Truvada.

Truvada is approved for use in Canada, but is not covered by provincial health plans. As a result, out of pocket cost, even with private health insurance, can be as much as $800/month.

Generic PrEP, or “generic Truvada”

Generic PrEP, or “generic Truvada”, shares many similarities with Truvada PrEP, but is not developed by Gilead. Most generic PrEP is manufactured by Apotex, Pharmascience, and JAMP. This lack of a strong, single company patent highlights generic PrEP’s biggest differentiator: accessibility. In Canada, provincial plans completely cover, or subside generic Truvada. This drastically cuts down the already low $250/month out of pocket cost for users.

As mentioned earlier, generic PrEP is a pill administered orally once a day, and has a 99% effectiveness rate of preventing HIV infection.


DESCOVY is similar to Truvada, in that they are both manufactured by Gilead Health. DESCOVY, the third PrEP drug highlighted, was created to combat the negative effects Truvada may have on kidney and bone health. This was achieved through the development of a new formulation of tenofovir called TAF (tenofovir alafenamide).

Despite the clear advantage Desovy has for bone health, it has the same efficacy rate in preventing HIV infections (99%). As a result, besides differences in bone and kidney reaction, there are few differences between DESCOVY and Truvada.

Similar to generic PrEP, the biggest differentiator is accessibility. In Canada, DESCOVY is not covered by provincial health insurance, and out-of-pocket costs are at least $1,000/month. However, in some provinces, such as British Columbia, patients with health insurance can be prescribed DESCOVY for little to no cost.

Which is better? DESCOVY, generic or Truvada?

Most importantly, all three forms of PrEP are 99% effective in preventing HIV infection. Due to differences in individual needs, it is important to refer to a healthcare professional and find out which option is best for you.

Choosing a PrEP medication

As highlighted above, accessibility is the biggest differentiating factor between the three highlighted PrEP options. Depending on an individual’s health insurance plan, and their own health history, one option may be a better fit than the others. This can vary by location, as provincial health plans and the scope of their coverage differ province to province.

Overall, this journey starts with a 1-on-1 consultation with a healthcare provider you trust in order to find the right plan for your individual health care needs.

Reviewed by:
Dr. Caley Shukalek

Caley is passionate about evidence-based, patient-centred care, including telemedicine that can provide high quality care from wherever a patient may choose.

He helped create Alberta's PrEP guidelines and works as a specialist in General Internal Medicine with additional training in sexual health, including HIV and sexually transmitted infections.

He holds an Masters of Public Health from Johns Hopkins University, an MD from the University of Calgary and an MSc from the University of Alberta.