Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, said coverage is vitally important for those at risk of HIV infection. “If somebody wants to be on PrEP, there’s a reason and you want to make it easy as possible,” Schmid said. “We’re still hearing complaints from all different parts of the country,” from people who forego the drug regimen over concerns about affordability.
The HIV+Hepatitis Policy Institute’s Carl Schmid summarized, “It’s not an issue of not wanting clinics that receive Ryan White Program funding to be engaged in PrEP, we think they are the perfect places for PrEP to be delivered. It is an issue of taking funding generated from caring and treating for people living with HIV away from the intended purpose of the Ryan White Program – to provide for people living with HIV. With so many people with HIV living longer, who are not in care or have fallen out of care, you would think that these Ryan White grantees would devote that money to people who are living with HIV, as it was intended.”
A U.S. federal judge in Texas last week threw into uncertainty the future of employer insurance coverage for people at risk of contracting HIV. But even before then, the uptake and coverage of drugs related to HIV prevention and treatment, especially newer injectable drugs, were already deficient and lacking proper enforcement, consumers, employers and public health experts say.
[U.S. District Judge Reed] O’Connor, despite citing the evidence that PrEP drugs reduce HIV spread through sex by 99% and through injection drug use by 74%, held that the government did not show a compelling governmental interest in mandating no-cost coverage of PrEP. “We’re trying to make it easier to get PrEP, and there are plenty of barriers already,” says Carl Schmid, executive director of the HIV + Hepatitis Policy Institute. “If first-dollar coverage went away, people won’t pick up the drug. That would be extremely damaging for our efforts to end HIV and hepatitis.”
Several patient groups are challenging a federal rule that allows health insurers to avoid counting the value of drug manufacturer copay assistance toward patients’ out-of-pocket cost obligations. The HIV+Hepatitis Policy Institute, the Diabetes Leadership Council and the Diabetes Patient Advocacy Coalition filed suit in the U.S. District Court for the District of Columbia in late August.