PEP Use in New York State
Post-Exposure Prophylaxis (PEP) is a key component of New York's Ending the Epidemic Initiative. These data show trends in PEP use in the NYS Medicaid Program beginning in 2012, by counting the number of Medicaid enrollees who filled PEP prescriptions.
Additional information on PEP
NYS Medicaid PEP beneficiaries | Cumulative from Jan 2012 - June 2021
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Data Source: NYS Medicaid Data Warehouse (MDW)

  • Administrative billing data. Interpret with caution.
  • Medicaid Program: Fee for service, managed care status determined at the time of initial PEP claim.
  • Age: Ages are calculated at the time of initial Truvada claim for PEP. Data is only shown for individuals ages 13+.
  • Sex, Race/ethnicity, Geographic Region: Sex/Race/Region are based on the latest information as of data extract date. Region is based on residence of Medicaid beneficiary. Claims and encounter data are subject to errors and omissions, specifically with regard to the race and ethnicity of recipients.

Additional Notes

  • Enrollees counted if filled at least one Truvada and Raltegravir or Dolutegravir within 1 day of each other during the analysis time period.
  • Count of beneficiaries are not cumulative and cannot be aggregated across time periods. Counts pertain only to the 6 or 12 month time period within which they are measured.
  • Exclusions:
    • Having a diagnosis of HIV (ICD-9 042 or V08 and ICD-10 B20 or Z21) which occurred on two separate encounters, 2 years prior to the first use of Truvada.
    • Having pharmacy claims for the following ARV agents during the analysis time period: W5C, W5I, W5J, W5K, W5L, W5M, W5N, W5P, W5Q, W5T, W5X, W5Z (therapeutic class).
    • Being on Truvada and Raltegravir and Dolutegravir at the same time.

CUNY Institute for Implementation Science in Population Health

New York State Department of Health

55 W 125th Street, New York, NY 10027