What is Lenacapavir and how does it work as PrEP?
Lenacapavir is a long-acting HIV prevention drug (PrEP) that is administered as an injection twice a year. In the European Union, it has been approved for preventive use under the brand name Yeytuo, with Gilead as the manufacturer. Early studies have shown near-total protection against HIV infection among certain groups, including young women in Uganda and South Africa, highlighting its potential to simplify prevention strategies. The injectable regimen offers an attractive alternative for people who struggle with daily pills or frequent clinic visits, potentially widening access to PrEP in diverse settings.
A dramatic price shift and market access
Traditionally, Lenacapavir PrEP has carried a high price in high-income markets, with annual costs cited around 420,000 kronor. Recognizing the barrier this poses for widespread use in lower‑ and middle‑income countries, Gilead announced agreements with generic manufacturers to lower prices where resources are limited. According to BBC reporting, from 2027 the drug is slated to be available for under 400 kronor in 120 low- and middle-income countries, thanks to a collaborative effort led by the Clinton Health Access Initiative (CHAI) in partnership with the Gates Foundation and other groups, including South Africa’s Wits Reproductive Health and HIV Institute (Wits RHI).
As Professor Saiqa Mullick of Wits RHI told BBC, for many LMICs access to affordable HIV prevention is not a luxury but a necessity. She noted Lenacapavir’s potential to transform prevention, especially for young people and underserved communities that frequently face barriers to regular clinic visits.
What the price cut means for people at risk
Lower prices open opportunities for national programs, NGOs, and community clinics to incorporate Lenacapavir PrEP into broader HIV prevention strategies. The long-acting injection is particularly appealing for populations with stigma, mobility, or logistical constraints that make daily regimens challenging. If affordability and supply remain stable, healthcare systems in LMICs could see improved uptake and continuity of PrEP among groups at highest risk.
Rollout and implementation
The real work begins now, experts say. Successful rollout will hinge on close collaboration with communities and governments to build demand, secure commitments, and prepare health systems for rapid deployment and scale‑up. This includes coordinating regulatory approvals, supply chains, provider training, and patient education to ensure that the benefits of lenacapavir are realized where they are most needed.
Scientific recognition
Lenacapavir has been highlighted by the scientific community as a landmark development. Science magazine named it the Breakthrough of the Year, calling it a pivotal step toward reducing HIV/AIDS as a global health crisis. While price reductions are essential, the broader impact will depend on the effectiveness of implementation and sustained investment in prevention infrastructure.
Conclusion
The price drop and the promise of expanded access in 120 LMICs reflect a broader shift in how new HIV prevention tools can reach those most in need. If the rollout is well managed and supported by ongoing partnerships, Lenacapavir PrEP could significantly reduce new HIV infections and reshape prevention landscapes across diverse communities.
