We need to make PreP free in Nova Scotia. As both an opposition MLA and a practicing doctor, I find it deeply concerning that in Nova Scotia only about 8% of people eligible for HIV pre-exposure prophylaxis (PrEP) are actually accessing this critical medication.
Below is a video excerpt from the Health Committee meeting on June 10, 2025, where I raised important questions about PrEP access and funding in Nova Scotia.
At the Health Committee on June 10, 2025, I challenged the government on this failure to provide universal access to PrEP despite strong evidence showing it saves lives and reduces healthcare costs.
Is PrEP free in Nova Scotia?
PrEP was introduced under Nova Scotia’s Pharmacare program in 2018, but it is far from universally free. Dr. Scott Wilby, Director of the College of Pharmacy, explained to the committee that while some people have coverage, many others do not. For those without Pharmacare or private insurance, the out-of-pocket cost for a three-month supply of PrEP is about $700—roughly $200 to $250 per month. This price tag is completely out of reach for many Nova Scotians, including students and people without stable employment.
This situation leaves key vulnerable populations—including gay, bisexual, and other men who have sex with men (MSM), as well as people who inject drugs—unable to access PrEP. These groups face disproportionate HIV risks and ongoing health inequities.
The CBC has reported on rising HIV cases in Nova Scotia and the calls from advocates and opposition parties for no-cost access to prevention medications like PrEP to reverse this trend . Community health organizations such as Sexual Health Nova Scotia also highlight cost as a major barrier despite education and outreach efforts .
Who is missing out on PrEP and why it matters
Dr. Wilby pointed out that although the 8% uptake figure is from a few years ago, the core issues remain. PrEP is more than just a medication; it’s part of a holistic program including regular testing and treatment for sexually transmitted infections (STIs). Studies have uncovered significant undiagnosed STIs in communities that might have been identified and treated if more people had access to PrEP.
Throughout Nova Scotia, many people—often marginalized and without a strong voice—are denied this vital prevention tool due to current funding and prescribing limitations.
The cost-effectiveness of universal PrEP access
So, is PrEP free in Nova Scotia? The answer is clearly no, and this failure to fund universal access represents a false economy. Treating HIV costs the healthcare system between $1,500 and $2,000 or more per month over a patient’s lifetime. Preventing HIV through PrEP is a far more cost-effective solution.
According to Dr. Robert Strang, Nova Scotia’s Chief Medical Officer of Health, new HIV cases have increased—from 1.5 to roughly 3 per 100,000 people between 2021 and 2024. The lifetime treatment cost for someone living with HIV is around $9,600 annually, placing a heavy burden on our healthcare system.
Evidence from British Columbia demonstrates that universal PrEP access significantly reduces new HIV cases. Dr. Strang affirmed that expanding PrEP access is a crucial strategy for reducing HIV transmission here in Nova Scotia. While a precise cost estimate for universal funding in this province has not been made, the data strongly suggest it would be a cost-effective public health investment .
Moving forward: the Province should fund universal access to PrEP
Despite these facts, the government has failed to make PrEP universally accessible. Pre-pandemic, proposals for universal PrEP funding were put forward within the Department of Health, but to date, no concrete action has been taken.
As both a doctor and an opposition MLA, I call on the government to do the right thing: the Province should fund universal access to PrEP. This will support marginalized populations, reduce stigma, and align Nova Scotia with other jurisdictions that have successfully decreased HIV rates through this intervention.
Let’s be clear—when people ask, “Is PrEP free in Nova Scotia?” the honest answer must change to yes. Let’s make PrEP free in Nova Scotia and close the unacceptable gap between eligibility and actual access.
The evidence is undeniable. Funding universal PrEP will save lives, improve health equity, and reduce long-term healthcare costs. The time for excuses is over. It’s time for decisive government action to protect Nova Scotians from HIV once and for all.
