HIV+Hep in the News

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Insurers must cover long-acting injectable PrEP, CMS says

by | Oct 21, 2024

Carl Schmid, executive director of the HIV+ Hepatitis Policy Institute, said in a statement before the new guidance, some insurers may have only covered daily oral PrEP. “With low uptake of PrEP among the communities most impacted by HIV, this insurance coverage requirement with zero cost-sharing will help jumpstart the use of more effective forms of PrEP and lead to fewer HIV transmissions,” Schmid said Monday (Oct. 21). “The updated USPSTF recommendation is not drug-specific, but rather for PrEP in general to prevent HIV which includes ‘effective antiretroviral therapy.’ This will be important as new longer acting PrEP drugs become available.”

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ViiV shows success in prevention, adherence to long-acting PrEP

by | Oct 17, 2024

The news comes after CMS released guidance switching PrEP from Medicare Part D to Part B, allowing all forms of the medication to be covered without cost-sharing. The HIV+Hepatitis Policy Institute, along with over 60 other advocates, had called on the administration to issue updated guidance to insurers to ensure coverage of all FDA-approved PrEP medications for HIV, including long-acting regimens.

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Biden’s inaction leaves copay assistance in limbo

by | Oct 14, 2024

Recent research by the HIV+Hepatitis Policy Institute has revealed that over 150 employers and insurers are taking advantage of the EHB loophole. This list includes: major companies such as Chevron, Citibank, Home Depot, Target, and United Airlines; universities including Harvard, Yale, and New York University; unions like the New York Teamsters and the Screen Actors Guild; states such as Connecticut and Delaware; and insurers, including several Blue Cross/Blue Shield plans. Patient advocacy groups have reacted strongly to these omissions. Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, stated, “Every day these rules are delayed is another day that insurers and PBMs are pocketing billions of dollars meant for patients who are struggling to afford their drugs.” This sentiment reflects the frustration of many who have long advocated for stronger protections.

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Mass. budget includes language expanding access to preventative HIV medications

by | Oct 14, 2024

Massachusetts joins 14 other states in allowing pharmacists to administer PrEP and the post-exposure PEP medications. Kevin Herwig, health policy manager of the HIV + Hepatitis Policy Institute, cited California as one of the earliest states to enact PrEP legislation in 2019 but had to expand its provision in 2024. “Because of the lessons they learned, (California) had to go back and pass a second law,” Herwig said. “So it’s important to learn from other states that are implementing it.”

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‘I’m another statistic. I feel let down’: How HIV prevention stays out of reach for many

by | Oct 13, 2024

Despite payer claims that they need a prior authorization to determine a patient’s risk, that is not their arena, Carl Schmid of the HIV+Hepatitis Policy says. “We don’t need an insurance company to determine if you’re at risk or not. That’s between the provider and the PrEP user.” Prior authorization is among the top-cited barriers to PrEP by clinicians.

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