PrEP

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HIV discrimination complaints filed in five states against insurers for substandard drug coverage & high cost-sharing

Nov 15, 2024

“We continue to uncover private insurers that engage in discriminatory plan design by using drug formularies that discourage enrollment of people living with HIV. Putting every HIV drug, including cheap generics, on the highest cost-sharing tier and not covering drugs necessary to treat HIV are blatant examples of discrimination,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “Without proper regulation and enforcement, some insurers will try to get away with whatever they can. We call on the state insurance regulators to act quickly on these complaints and immediately ensure these insurers come into compliance.”

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HIV+Hepatitis Policy Institute comments on 2024 election results

Nov 6, 2024

The American people have spoken and elected Donald Trump and JD Vance as our next President and Vice President. The HIV+Hepatitis Policy Institute will work with the new administration on furthering efforts to end HIV and hepatitis in the United States. With proper leadership, policies, and funding, we can end both these infectious diseases.

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Biden-Harris administration requires insurers to cover long-acting PrEP to prevent HIV

Oct 21, 2024

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. We are grateful to the Biden-Harris administration for responding to our request to issue this guidance. Without it, we feel some insurers would continue to only cover daily oral PrEP, and not provide PrEP users with the choice they need.  With up to a third of privately insured PrEP users still being charged cost-sharing, we must ensure that both federal and state regulators vigorously enforce PrEP coverage requirements.

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Medicare Beneficiaries Can Now Access PrEP Without Cost-Sharing

Sep 30, 2024

“We commend the Biden-Harris administration for increasing PrEP uptake using all the tools at its disposal. Patient cost-sharing has been a significant barrier for Medicare beneficiaries. With this new NCD, people on Medicare can join those with private insurance who can access PrEP without cost-sharing. Now we have to make sure these policies are properly implemented and enforced,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute.

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Twice a Year HIV Prevention Drug May Soon Be Available

Sep 12, 2024

The goal now must be to ensure that people who have a reason to be on PrEP are able to access this miracle drug. Thanks to the ACA, insurers must cover PrEP without cost-sharing as a preventive service.  Insurers should not be given the choice to cover just daily oral PrEP, particularly given these remarkable results . The Biden-Harris administration should immediately make that clear.  To date, they have yet to do that for the first long-acting PrEP drug that new plans now must cover.

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ACA Appropriations Biden administration CDC Congress Copay accumulators Copay assistance Cost-sharing COVID-19 Drug Pricing FDA Gay men healthcare Hepatitis Hepatitis B Hepatitis C hepatits HIV HIV Prevention hous housing insurer Insurers LGBT Medicaid Medicare Part D NAIC NIH PBMs PrEP Prescription Drugs prevention Private Insurance Ryan White Ryan White Program state Syringe services Testing transparency Treatment Trump administration

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