Yeztugo (Lenacapavir) Cost: How Much Is the Twice-Yearly PrEP Injection?
Yeztugo is the first PrEP option that requires only two injections per year. It showed extraordinary clinical results — but the list price is $28,218/year. Here's what you'll actually pay and how to get it for $0.
Yeztugo Cost Breakdown
| Situation | Your Cost | Details |
|---|---|---|
| List price (no insurance, no assistance) | ~$14,109/injection (~$28,218/year) | Two subcutaneous injections per year after oral loading |
| Private insurance (ACA-compliant) | $0 | Covered as preventive care — no copay, no deductible |
| Gilead Co-Pay Savings (commercially insured) | $0 | Up to $8,000/year + $100/visit for injection administration |
| Gilead MAP (uninsured, ≤500% FPL) | $0 | Free medication; no SSN required; FedEx overnight shipping |
| Medicaid | $0 | Covered under preventive services; prior authorization may apply |
| Medicare Part B | Cost-sharing applies | Manufacturer copay cards excluded; nonprofit funds may help |
Clinical Results
Yeztugo (lenacapavir) was approved by the FDA on June 18, 2025 — the first twice-yearly HIV prevention option. The clinical trial results were extraordinary:
The PURPOSE 1 trial in cisgender women showed zero HIV infections — 100% risk reduction. The PURPOSE 2 trial across a diverse population (cisgender men, transgender men, transgender women, and gender non-binary individuals) showed only 2 infections — a 96% risk reduction. Science magazine named lenacapavir the 2024 Breakthrough of the Year.
How to Get Yeztugo for Free
If you have commercial insurance: PrEP is covered at $0 under the ACA. If your plan charges anything, Gilead's Co-Pay Savings Program covers up to $8,000/year in out-of-pocket costs plus $100 per visit for injection administration. No income restriction. Call 1-877-505-6986 or visit prep.advancingaccess.com.
If you're uninsured: Gilead's Medication Assistance Program (MAP) provides Yeztugo free to patients with income at or below 500% of the Federal Poverty Level (~$79,800/year for an individual). No SSN required. Medication can ship via FedEx overnight. Call 1-800-226-2056 or visit gileadadvancingaccess.com.
If you're on Medicaid: Yeztugo is covered as a preventive service at $0 cost-sharing. Prior authorization may be required given the high list price. Your provider handles the paperwork.
Yeztugo vs. Apretude: Injectable PrEP Comparison
| Yeztugo (Lenacapavir) | Apretude (Cabotegravir) | |
|---|---|---|
| Manufacturer | Gilead Sciences | ViiV Healthcare |
| Frequency | Every 6 months | Every 2 months |
| Injection type | Subcutaneous (belly area) | Intramuscular (gluteal) |
| Annual list price | ~$28,218 | ~$24,000 |
| Annual visits | 2 (after loading) | 6 (after loading) |
| Free for uninsured? | Yes — Gilead MAP | Yes — ViiVConnect PAP |
| Approved | June 2025 | December 2021 |
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Insurance Coverage Status
CMS approved HCPCS J-codes for Yeztugo effective October 1, 2025, which means Medicare, Medicaid, and commercial plans can now process claims. Most private insurers are covering it under the ACA preventive care mandate, though prior authorization is common given the high cost.
If your insurer denies coverage or requires excessive prior authorization, your provider can appeal. Gilead also has a dedicated support team to help with insurance issues: 1-800-226-2056.
What's Next: Once-Yearly Lenacapavir
Gilead has a once-yearly lenacapavir formulation in Phase III clinical trials, with results expected around 2028. If approved, PrEP could become a single annual injection. Generic lenacapavir production is also expected by 2027 for lower-income countries at roughly $40 per person per year through agreements with the Gates Foundation and Unitaid.