CVS health refusing to cover new long-acting PrEP drug

Clear Violation of Affordable Care Act Preventive Services Requirement

Washington DC… In response to yesterday’s announcement that CVS Health’s commercial plans will not cover Yeztugo, the recently FDA-approved, extremely effective twice-yearly HIV prevention drug—nor offer it as a preventive service without patient cost-sharing—Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, issued the following statement:

“CVS Health’s decision is a clear violation of the ACA’s requirement to cover USPSTF-recommended preventive services, including PrEP. The entire world is excited by this drug and its potential contribution to preventing and eventually ending HIV. However, a drug will only work if people can access it and right now CVS Health, which owns the largest pharmacy benefit manager in the country, is shamefully blocking people from taking it, unlike other payers. We urge CVS, which has been committed to ending HIV in the past, to reconsider their decision immediately. Additionally, we call on federal and state regulators to ensure that plans are in compliance with the federal government’s PrEP coverage guidance and the many state laws that require coverage of all PrEP drugs.”

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The HIV+Hepatitis Policy Institute is a national, non-profit organization whose mission is to promote quality and affordable healthcare for people living with or at risk of HIV, hepatitis, and other serious and chronic health conditions.