While we support efforts to make prescription drugs more affordable, we respectfully urge you to oppose Delaware Senate Joint Resolution 7 because it would impose harmful and untested price controls in state employee health plans without guaranteeing savings for patients.
While we support efforts to make prescription drugs more affordable, we respectfully urge you to veto Assembly Bill 259 because it would impose harmful and untested price controls without guaranteeing savings for patients. AB 259 would prohibit any entity in Nevada from purchasing or seeking reimbursement for a prescription drug at a price higher than the flawed and untested federally determined Maximum Fair Price (MFP), as established under the Inflation Reduction Act (IRA). This effectively creates a blanket price cap for all state regulated health plans, based on prices negotiated exclusively for Medicare beneficiaries.
On behalf of the HIV+Hepatitis Policy Institute, an organization dedicated to promoting quality and affordable healthcare for people living with or at risk of HIV, hepatitis, and other serious and chronic health conditions, we thank you for this opportunity to comment on a National Coverage Determination (NCD) by the Centers for Medicare and Medicaid Services (CMS) on the use of provider-administered pre-exposure prophylaxis (PrEP). The first provider-administered medication for HIV pre-exposure prophylaxis (Apretude or cabotegravir as PrEP) was approved by the Food and Drug Administration in January 2022. In August 2022, we wrote to you on behalf of 64 organizations to request that CMS quickly and efficiently evaluate provider-administered PrEP for a National Coverage Determination, which is the only pathway to coverage under Medicare Part B. We commend CMS on moving forward with the NCD process and urge CMS to approve the NCD for provider-administered PrEP.
We offer our strong support of adding HIV/AIDS as one of the chronic conditions to be included in the Medicare Part D Medication Therapy Management (MTM) program. The MTM program is designed to assure, with respect to targeted beneficiaries, that covered Part D drugs are appropriately used to optimize therapeutic outcomes through improved medication use, and to reduce the risk of adverse events, including adverse drug interactions.
We are pleased that the Centers for Medicare and Medicaid Services (CMS) has accepted a request for a National Coverage Determination (NCD) for cabotegravir, a new long-acting injectable form of pre-exposure prophylaxis (PrEP) to prevent HIV. A National Coverage Determination is the only pathway to coverage under Medicare Part B for a provider-administered drug. We have, however, been disappointed to learn that CMS has given no timeline for action on this National Coverage Determination, which will make this new long-acting PrEP medication out of reach for potential PrEP users. Combined with a USPSTF recommendation, an NCD will also make the drug available to Medicare Part B beneficiaries without cost-sharing, thus eliminating one of the biggest barriers to PrEP uptake.