TL;DR
Yeztugo (lenacapavir) list price is $28,218/year — or ~$14,109 per injection, given every 6 months. Gilead's copay savings program covers up to $8,000/year plus $100 per injection visit for commercially insured patients, typically bringing your cost to $0. Uninsured patients under 500% FPL qualify for free Yeztugo through Gilead Advancing Access (no SSN required). Medicaid coverage is rolling out state-by-state following CMS J-code approval in October 2025.
What is Yeztugo?
Yeztugo is the brand name for lenacapavir, manufactured by Gilead Sciences. FDA-approved on June 18, 2025, it became the first twice-yearly HIV prevention option — two subcutaneous injections every six months, after an oral loading period. That's just two clinic visits per year for HIV prevention.
Clinical results were extraordinary. In the PURPOSE 1 trial (cisgender women in sub-Saharan Africa), zero participants acquired HIV — a 100% risk reduction. In PURPOSE 2 (a more diverse population including transgender and cisgender men), only 2 participants acquired HIV, a 96% risk reduction. Both results outperformed daily oral PrEP. Science magazine named lenacapavir its 2024 Breakthrough of the Year.
Yeztugo list price: what Gilead charges
Gilead set Yeztugo's list price at $28,218 per year for the two injections needed for year-round protection. That works out to approximately $14,109 per injection, plus the oral loading doses required during transition.
| Yeztugo pricing | Detail |
|---|---|
| $28,218 | Annual list price (2 injections) |
| ~$14,109 | Per injection (given every 6 months) |
| + admin fees | Clinic charges for each injection visit |
| + oral loading | Oral pills during transition phase |
The pricing made headlines and prompted public criticism — researchers have shown Yeztugo could be manufactured for as little as $26–$40 per person per year. Gates Foundation and Unitaid have arranged generic production at $40/year for 120 low- and middle-income countries starting in 2027. In the U.S., however, patent protection keeps the list price where Gilead sets it.
That said, the list price isn't what most Yeztugo users actually pay. Between Gilead's copay savings program, Medication Assistance Program, and growing insurance coverage, most patients pay $0 out of pocket.
Yeztugo cost with commercial insurance
If you have commercial insurance, Yeztugo is increasingly covered — though coverage is still being built out across formularies. As of early 2026, most major commercial insurers cover Yeztugo under the medical benefit (since it's provider-administered), typically requiring prior authorization.
Gilead Yeztugo Copay Savings Program: $8,000/year + $100/visit
Gilead's copay savings program for Yeztugo is one of the most generous in HIV prevention. Commercially insured patients can receive:
- Up to $8,000/year in drug copay assistance
- $100 per injection visit toward administration fees
For most commercially insured patients, this brings the out-of-pocket cost to $0. Enroll at GileadAdvancingAccess.com. The program excludes Medicare, Medicaid, Tricare, and VA coverage.
Yeztugo cost with Medicaid
CMS approved HCPCS J-codes for Yeztugo effective October 1, 2025, which officially allowed Medicaid programs to bill and cover the drug. Coverage is now rolling out state-by-state. Most state Medicaid programs either already cover Yeztugo at $0 copay under the ACA preventive services mandate, or are in the process of adding it to their formularies.
If your state Medicaid plan denies Yeztugo, appeals are often successful — the ACA mandate for PrEP coverage without cost-sharing applies to the full range of FDA-approved PrEP options.
Yeztugo cost with Medicare
Medicare Part B covers Yeztugo following the October 2025 J-code approval. As with other Part B-covered drugs, Medicare covers 80% of the approved amount after your deductible; Medigap or Medicare Advantage plans typically cover the remaining 20%.
Medicare beneficiaries cannot use Gilead's commercial copay card but may qualify for Good Days Foundation copay assistance (up to $7,500/year, income limit 500% FPL).
Thinking about twice-yearly injectable PrEP?
MISTR providers can evaluate whether Yeztugo is right for you, coordinate Gilead patient assistance, and help arrange a local injection provider — all through one free online consultation.
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Yeztugo without insurance: how to get it free
1. Gilead Advancing Access Medication Assistance Program Best for uninsured
Gilead's direct patient assistance program provides free Yeztugo to uninsured patients with household income ≤500% of the Federal Poverty Level (~$75,300/year for an individual in 2026). Apply at GileadAdvancingAccess.com or call 1-800-226-2056. Critically, SSN is not required and undocumented residents are explicitly eligible. Free medication ships via FedEx overnight to a home, clinic, shelter, or FedEx location. Administration fees at the injection site may still apply.
2. Telehealth platforms Growing option
Telehealth platforms are rapidly adding injectable PrEP — including Yeztugo — to their offerings. These services can prescribe Yeztugo and coordinate patient assistance for qualifying uninsured patients. You'll still need to visit a local clinic for the actual injection, but the medication cost and coordination can be handled through telehealth.
3. Ryan White HIV/AIDS Program clinics Income-based
Ryan White-funded clinics in most states provide injectable PrEP access for low-income uninsured patients. Find a clinic at locator.hiv.gov. Access to Yeztugo specifically depends on the clinic's formulary decisions and 340B arrangements.
Yeztugo vs other PrEP options: cost comparison
| Drug | Dosing | List price/year | With assistance |
|---|---|---|---|
| Yeztugo (lenacapavir) | Injection every 6 mo | $28,218 | $0 |
| Apretude (cabotegravir) | Injection every 2 mo | ~$24,228 | $0 |
| Descovy (FTC/TAF) | Daily pill | ~$26,160 | $0 |
| Generic Truvada (TDF/FTC) | Daily pill | ~$360 cash* | $0 |
*Cash price with GoodRx coupon at most U.S. pharmacies.
Yeztugo's list price is the highest of any PrEP option, but the dosing convenience — just two injections a year — is unmatched. For people who struggle with adherence to daily pills and can't commit to every-two-month Apretude visits, Yeztugo is genuinely transformative.
Get PrEP started today while you decide on Yeztugo
Yeztugo requires lab work and coordination. MISTR can start you on oral PrEP at $0 today (with discreet home delivery) while coordinating your transition to injectable PrEP in parallel.
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When will generic Yeztugo be available?
Not anytime soon in the U.S. Gilead holds patents on lenacapavir that are expected to prevent U.S. generic entry until at least 2033. The Gates Foundation and Unitaid have arranged generic production at $40/person/year for 120 low- and middle-income countries starting in 2027 — but this arrangement does not include the United States, where patent protection remains in force.
A once-yearly lenacapavir formulation is currently in Phase III trials, with results expected around 2028. If approved, it would require only one injection per year.
Frequently asked questions
How much does Yeztugo cost without insurance?
Retail list price is $28,218 per year, or approximately $14,109 per injection. However, uninsured patients under 500% of the Federal Poverty Level qualify for free Yeztugo through Gilead's Medication Assistance Program — no SSN required.
How often do you need Yeztugo injections?
Two injections per year — once every six months — after an oral loading dose period during transition. It's the only twice-yearly PrEP currently available.
Is Yeztugo covered by insurance?
Most commercial insurers now cover Yeztugo, typically under the medical benefit with prior authorization. Medicaid coverage is rolling out state-by-state following CMS J-code approval in October 2025. Medicare Part B covers Yeztugo as a provider-administered drug.
How does Yeztugo compare to Apretude?
Both are injectable PrEP, but dosing differs: Yeztugo is subcutaneous every 6 months (2 visits/year); Apretude is intramuscular every 2 months (6 visits/year). Yeztugo is slightly more expensive at list price but offers dramatically more convenient dosing. Both achieve $0 cost for most patients through assistance programs.
What's the Yeztugo copay card?
Gilead's Yeztugo copay savings program covers up to $8,000/year in drug copays plus $100 per injection administration visit for commercially insured patients. It's not available for Medicare, Medicaid, or other government insurance beneficiaries.
Can I get Yeztugo through a telehealth platform?
Yes, with logistics. Some telehealth platforms can prescribe Yeztugo and coordinate patient assistance, but you'll need to visit a local clinic for the actual injection. Several platforms are actively expanding their injectable PrEP offerings throughout 2026.
Is there a generic version of lenacapavir?
Not in the United States. Generic lenacapavir will be available in 120 low- and middle-income countries starting in 2027 through a Gates Foundation/Unitaid partnership, but patent protection in the U.S. is expected to prevent domestic generic entry until at least 2033.
Get PrEP at $0 — and get Yeztugo coordinated for you
MISTR provides free oral PrEP delivered to your home and can coordinate injectable PrEP (Yeztugo, Apretude) with manufacturer patient assistance handled by their team.
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