HIV+Hep in the News

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Formulary changes by BCBS NC will reduce HIV, generic drug costs

by | Sep 1, 2023

HIV+Hepatitis Policy Institute Executive Director Carl Schmid is hopeful Blue Cross NC’s decision will serve as a wake-up call for other insurers to adjust their formularies in a non-discriminatory manner, but he told Inside Drug Pricing that more complaints may need to be filed and consumers will need to be careful when selecting health plans for 2024. “While pleased to see this dramatic turnaround by the insurer, blatant discriminatory plan design and violation of the ACA’s patient protections should not happen in the first place,” Schmid said in a statement. “Insurers seem to try to get away with as much as they can until they are caught. For insurance to work for patients, we need better federal and state regulation, oversight, and enforcement. A drug formulary with adverse tiering should never be approved.”

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Action Alert: HIV Leaders to Meet at Capitol Hill to #SaveHIVFunding

by | Sep 1, 2023

“Given that the House version of the bill includes sizeable funding cuts, program eliminations and divisive policy riders, we realize passage of [the Senate] spending bill is far from reality,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, when the bills were passed in July. “Republicans must come to the table and support bills, such as this one, that can pass the Congress and be signed by the president.”

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Panel’s endorsement paves the way for insurance coverage of injectable PrEP

by | Aug 29, 2023

The HIV+Hepatitis Policy Institute, which is a national non-profit working to promote affordable and quality care for people living with or at risk of HIV and hepatitis, also praised the “A” rating nearly two years after the organization led 62 other groups in asking the panel to recommend injectable PrEP. “Including a long-acting drug as part of the USPSTF PrEP recommendation is an important step in improving HIV prevention efforts in the United States,” Carl Schmid, executive director, said in a written statement. “While daily oral PrEP is highly effective, adherence can be an issue. That is why the FDA called long-acting PrEP superior to daily oral PrEP.”

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Key predictions in the accumulator/maximizer battle

by | Aug 25, 2023

Comparatively speaking, the case of HIV and Hepatitis Policy Institute et al. v. U.S. Department of Health and Human Services et al is much further along in its efforts to ban accumulators nationally. Filed a year ago, the plaintiffs allege that accumulators violate the Affordable Care Act and Administrative Procedure Act, while defendants believe eliminating accumulators will “encourage patients to use more expensive medications over less costly treatments, and also contribute to higher drug and health care spending and thus higher premiums.”

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New PrEP medication recommendation adds options for HIV patients

by | Aug 23, 2023

Among people who are eligible to receive PrEP, 78 percent of white people already had begun taking this medication by 2021, according to federal data. By comparison, only 11 percent of Black people who are eligible to take PrEP had started. This discrepancy may be especially pronounced for vulnerable populations, including people who are unhoused or who are struggling with substance use, as well as people whose work situations make getting a prescription refill logistically difficult, said Carl Schmid, executive director for the HIV+Hepatitis Policy Institute. “People seeking PrEP must not face any additional barriers as they seek to access the form of PrEP that best meets their individual needs,” Schmid said.

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