My name is Kevin Herwig, Health Policy Director at the HIV+Hepatitis Policy Institute, a national advocacy organization for people affected by HIV, hepatitis, and other serious or chronic conditions. Thank you for the opportunity to submit public testimony.
Though Connecticut’s statutory exclusion of antiretrovirals from the Medicaid Preferred Drug List has ended, we continue to oppose adding any antiretrovirals for HIV treatment or prevention to the PDL with non-preferred status, which would enable prior authorization and step therapy on those drugs.
HIV treatment selection is highly individualized, based on viral resistance profiles, comorbidities, drug interactions, and tolerability. For over two decades, Connecticut protected people with HIV from utilization management on the antiretroviral drugs they need. Barriers like prior authorization cause non-medical switching and treatment interruptions, falling hardest on the lowest-income, most vulnerable people with HIV, who are seen predominantly in safety-net clinics lacking the staff time and resources to triage utilization management.