“We must not allow a couple of individuals who want to discriminate against people who use PrEP and don’t support insurance coverage of preventive services, such as HIV and hepatitis B and C testing, to destroy the public health of our country,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, in a statement. “We filed this amicus brief to emphasize the important role testing for HIV and hepatitis plays in linking people to life-saving medications and, in the case of hepatitis C, curative treatment, along with the importance of helping people know if they have an infectious disease. Additionally, we take issue with the claim that PrEP is only for certain groups of people, to whom the plaintiffs object. PrEP is for anyone who may be at risk of HIV, and no employer knows or should know who those people are.”
Most people who need hepatitis C treatment aren’t getting it
“We have a cure for a serious infectious disease, but people who have taken the time to get tested and know they have hepatitis C are not being cured,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “The vast majority of these people have health coverage but payers such as private insurers, state Medicaid programs and Medicare are erecting barriers to patient access by not covering medications or requiring cumbersome prior authorizations or imposing high patient cost-sharing. If the federal government is serious about ending hepatitis C, it needs to provide the leadership, particularly at [the Centers for Medicare & Medicaid Services], and address these payer barriers.”
DOJ Defends USPSTF’s Role In Opening Brief In Braidwood Appeal
“We must not allow a couple of individuals who want to discriminate against people who use PrEP and don’t support insurance coverage of preventive services, such as HIV and hepatitis B and C testing, to destroy the public health of our country,” Carl Schmid, executive director of the HIV+Hepatitis Policy Institute says. “We filed this brief to emphasize the important role testing for HIV and hepatitis plays in linking people to life-saving medications and, in the case of hepatitis C, curative treatment, along with the importance of helping people know if they have an infectious disease. Additionally, we take issue with the claim that PrEP is only for certain groups of people, to whom the plaintiff’s object. PrEP is for anyone who may be at risk of HIV, and no employer knows or should know who those people are,” he adds.
Medicare part D redesign will sharpen policy focus on protected classes
“This is a big concern of ours–the unintended consequences of the IRA–because of the out-of-pocket cap/benefit redesign and the drug negotiation process,” Carl Schmid of the HIV+Hepatitis Policy Institute told the Pink Sheet. “Plans may want to have fewer drugs on the formularies, and there could be more utilization management including prior authorization. And this may result in more pressure to change the six protected classes.” Although there is currently no utilization management for HIV drugs, “the plans may push for changes of these existing policies,” he suggested.
Here’s why most at-risk populations don’t use HIV prevention drugs
Carl Schmid is the executive director of the HIV+Hepatitis Policy Institute, which has pressed health insurers to cover the costs of lab testing and medical visits that people need to get and stay on the medication. But he said those costs also can be a barrier to care for those who are uninsured and can’t afford such services. “They can get the drug for free – that’s not a question,” said Schmid. “It’s the labs. You have to have a doctor’s visit to get a prescription. And those things aren’t free.”